J Clin Oncol: Neoadjuvant DOS chemotherapy can further improve the prognosis of patients with resectable locally advanced gastric cancer on the basis of standard therapies

Adjuvant chemotherapy after D2 gastrectomy is locally advanced resectable in AsiaStandard treatment for gastric cancer (LAGC)
.
Based on the positive results of the perioperative chemotherapy in the European phase III study, the researchers conducted a similar phase III PRODIGY trial in Korean patients, aiming to compare neoadjuvant docetaxel, oxaliplatin and S -1 (DOS) chemotherapy followed by surgery and adjuvant S-1 can improve the prognosis of patients with resectable LAGC

The trial recruited 20-75 years old, ECOG performance status of 0-1, and histologically confirmed primary gastric cancer or gastroesophageal junction adenocarcinoma (clinical TNM staging: T2-3N+ or T4Nany), and randomized to the SC group (D2 surgery + auxiliary S-1) or CSC group (neo-adjuvant DOS [Docetaxel + oxaliplatin + S-1] + D2 surgery + S-1) group
.
The primary endpoint is progression-free survival (PFS)

From January 18, 2012 to January 2, 2017, 266 patients were assigned to the CSC group and 264 patients were assigned to the SC group.
In the end, 238 and 246 patients in the two groups received the study treatment
.
As of the last follow-up on January 21, 2019, the median follow-up was 38.

PFS of two groups

Compared with the SC group, the PFS of the CSC group was significantly improved (adjusted hazard ratio 0.
70, 95% CI 0.
52-0.
95; p=0.
023)
.
Sensitivity analysis verified this result

Original source:

Yoon-Koo Kang, et al.