Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): 5-year follow-up of an open-label, randomised phase 3 trial

Noh, Sung Hoon; Park, Sook Ryun; Yang, Han Kwang; Chung, Hyun Cheol; Chung, Ik Joo; Kim, Sang Woon; Kim, Hyung‐Ho; Choi, Jin Hyuk; Kim, Hoon Kyo; Yu, Wei; Lee, Jong Inn; Shin, Dong Bok; Ji, Jiafu; Chen, Jen Shi; Lim, Yunni; Ha, Stella; Bang, Yung Jue

doi:10.1016/s1470-2045(14)70473-5

Cited by 840 publications

(731 citation statements)

References 21 publications

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“…Surgical resection, either alone or in combination with perioperative chemotherapy or adjuvant chemotherapy, or chemoradiation is the main curative treatment for locally advanced gastric cancer (1)(2)(3). Malnutrition has been widely recognized in gastric cancer patients because of the disease itself or because of the surgical and oncological treatments (4,5).…”

Section: Introductionmentioning

confidence: 99%

Weight loss and quality of life in patients surviving 2 years after gastric cancer resection

Climent

Munarriz

Blazeby

et al. 2017

European Journal of Surgical Oncology (EJSO)

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Section: Introductionmentioning

confidence: 99%

Weight loss and quality of life in patients surviving 2 years after gastric cancer resection

Climent

Munarriz

Blazeby

et al. 2017

European Journal of Surgical Oncology (EJSO)

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“…Patients in the XELOX arm had improved 3-year DFS (74% vs. 59%, P0.0001) and OS (83% vs. 78% P=0.0493) [21]. After 5 years follow up, the XELOX arm had significantly better 5-year DFS (68% vs. 53%, P<0.0001) and 5-year OS (78% vs. 69%, p=0.0029) [22].…”

Section: Discussionmentioning

confidence: 90%

Adjuvant Capecitabine and Oxaliplatin vs. Capecitabine and Paclitaxel in Gastric Cancer Patients after D2 Gastrectomy

Sun¹,

He²,

Lin³

et al. 2017

J Carcinog Mutagen

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Objective: This retrospective study was carried out to compare the safety and efficacy of adjuvant capecitabine/ oxaliplatin (XELOX) versus capecitabine/paclitaxel (XP) in gastric cancer patients after D2 gastrectomy. Methods:The hospital records of the First Affiliated Hospital of Nanjing Medical University from 2008-2012 were searched to identify patients treated with adjuvant XELOX or XP after D2 gastrectomy and their clinicopathological data were retrieved. Disease-free survival (DFS) and overall survival (OS) were analyzed by Kaplan-Meier method with log-rank test.Results: A total of 144 stage I-III patients who received adjuvant XELOX (n=89) or XP (n=55) after D2 gastrectomy were identified. The median follow-up time was 47.0 (25.0-80.0) months. The 3-year DFS and OS rate was 67.0% versus 50.8% (p=0.047) and 74.8% versus 63.5% (p=0.184) in the XELOX and XP group respectively. XELOX significantly reduced the risk of relapse at three years (HR 0.60, 95% CI 0.36-0.99) but did not reduced the risk of death at the third year (HR 0.66,) compared with that treated with XP. Conclusions:These results indicate that adjuvant XELOX after D2 gastrectomy has a clinical advantage over XP; however, prospective studies are needed to verify this finding.

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“…The CLASSIC study was an open-label, parallel-group, multiregion (mainland China, Taiwan and South Korea), Phase III RCT that compared surgery with and without XELOX adjuvant chemotherapy in stage II-IIIB GC patients who had undergone D2 dissection [8,11]. Analysis of the Chinese subgroup (n = 100) showed a significantly higher 3-year DFS rate (78 vs 56%, HR: 0.56; p < 0.0001) and a reduced risk of relapse (59% reduction, p = 0.013) in the surgery + XELOX group than in the surgery-only group; however, the 3-year overall survival (OS) rate was similar in the two arms (78 vs 66%; p = 0.110).…”

Section: Capecitabine-based Chemotherapymentioning

confidence: 99%

“…Analysis of the Chinese subgroup (n = 100) showed a significantly higher 3-year DFS rate (78 vs 56%, HR: 0.56; p < 0.0001) and a reduced risk of relapse (59% reduction, p = 0.013) in the surgery + XELOX group than in the surgery-only group; however, the 3-year overall survival (OS) rate was similar in the two arms (78 vs 66%; p = 0.110). Grade III or IV adverse events (AEs) in the surgery + XELOX group included neutropenia (63.5%), thrombocytopenia (36.5%), vomiting (44.2%), decreased appetite (34.6%) and loss of bodyweight (23.1%) [8]. Similar with results were recorded in the overall population of the CLASSIC study, indicating that adjuvant XELOX chemotherapy improved outcomes in patients with AGC after D2 gastrectomy and had an acceptable safety profile [8].…”

Section: Capecitabine-based Chemotherapymentioning

confidence: 99%

A review of capecitabine-based adjuvant therapy for gastric cancer in the Chinese population

Cheng

2018

Future Oncology

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In China, the treatment of locally advanced gastric cancer (AGC) faces unique challenges. Chinese patients may harbor more unfavorable prognostic factors than western populations and, in comparison with other Asian populations such as Japan and South Korea, a higher proportion of Chinese patients are diagnosed with AGC due to inadequate early diagnosis of the malignancy. This review summarizes the use of combination chemotherapy regimens with capecitabine as adjuvant therapy in the Chinese AGC population. Based on the available domestic data in China, the review concludes that capecitabine-based chemotherapy regimens, especially XELOX, offer good efficacy following radical gastrectomy in patients with AGC, with a low incidence of adverse events, acceptable tolerance, greater patient convenience and a lower overall cost than other regimens.

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Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): 5-year follow-up of an open-label, randomised phase 3 trial

Cited by 840 publications

References 21 publications

Weight loss and quality of life in patients surviving 2 years after gastric cancer resection

Weight loss and quality of life in patients surviving 2 years after gastric cancer resection

Adjuvant Capecitabine and Oxaliplatin vs. Capecitabine and Paclitaxel in Gastric Cancer Patients after D2 Gastrectomy

A review of capecitabine-based adjuvant therapy for gastric cancer in the Chinese population

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