Capecitabine and cisplatin with or without cetuximab for patients with previously untreated advanced gastric cancer (EXPAND): a randomised, open-label phase 3 trial

Lordick, Florian; Kang, Yoon Koo; Chung, Hyun Cheol; Salman, Pamela; Oh, Sang Cheul; Bodoky, G.; Kurteva, G.; Volovăţ, Constantin; Moiseyenko, Vladimir; Gorbunova, Vera; Park, Joon Oh; Sawaki, Akira; Çelik, I.; Götte, Heiko; Melezínková, Helena; Moehler, Markus

doi:10.1016/s1470-2045(13)70102-5

Cited by 734 publications

(507 citation statements)

References 39 publications

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“…This study, however, did not find significant effects of these features on survival, except for lymph node metastasis of primary cancer. Many chemotherapeutic protocols for gastric cancer have been investigated over the past decades, and some regimens have been shown to prolong the survival of patients with metastatic gastric cancer [3,29,31,34]. In particular, 5-fluorouracil derivatives and cisplatin have been used as standard drugs for gastric cancer treatment since 2010 [3].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302)

et al. 2015

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Background The necessity of surgical treatment of liver metastases of gastric cancer is still controversial. Patients and methods We conducted a multicenter retrospective cohort study of liver-limited metastasis of gastric cancer treated surgically between 2000 and 2010. In this study, 103 patients were registered, with nine patients excluded from the analysis as they did not meet the eligibility criteria.Results Of the 94 patients, 69 underwent surgical resection, 11 underwent surgical resection combined with radiofrequency ablation or microwave coagulation therapy for small or deep tumors, and 14 underwent radiofrequency ablation or microwave coagulation therapy only. Synchronous and metachronous metastases were found in 37 and 57 patients, respectively. The 3-and 5-year overall survival rates of all the patients were 51.4 and 42.3 %, respectively. The 3-and 5-year relapse-free survival rates were 29.2 and 27.7 %, respectively. No significant difference in prognosis was observed between the patients who underwent surgical resection and those who underwent ablation therapy. The patients with hepatic solitary lesions and low-grade lymph node metastases of primary gastric cancer had significantly better overall survival and relapsefree survival. Conclusions To our knowledge, this study is the largest series and first multicenter cohort study of liver-limited metastasis of gastric cancer. The study indicated that patients with a single liver metastasis with a grade lower than N2 lymph node metastasis of the primary lesion are the best candidates for liver resection.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302)

et al. 2015

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“…Although no superior survival was shown with the combination cisplatin/S-1, significant safety advantages were observed compared to cisplatin/5-FU. Cisplatin and capecitabine has become the standard backbone chemotherapy in trials investigating monoclonal antibodies in GC [10,35,36]. In the treatment of elderly or frail patients, or in cases where platinum agents are contraindicated, singleagent fluoropyrimidine, although not as effective as doublet regimens, should also be considered an option [37,38].…”

Section: Methodsmentioning

confidence: 99%

Optimal chemotherapy for advanced gastric cancer: is there a global consensus?

et al. 2013

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“…The ToGA (Trastuzumab for Gastric Cancer) trial has shown that trastuzumab improves the survival of patients with HER2 protein-overexpressing and/or HER2 geneamplifying advanced gastric cancer [5]. Although the addition of cetuximab or panitumumab to chemotherapy in non-molecularly selected gastric cancer patients did not improve survival [6,7], a phase 2 study has shown a possible improvement in the survival of the patient subset with high EGFR expression who were treated with nimotuzumab, a humanized monoclonal antibody to EGFR [8]. At present, a phase 3 nimotuzumab trial (ENRICH study) in patients with EGFR-overexpressing advanced gastric and gastroesophageal junction cancer is ongoing.…”

Section: Introductionmentioning

confidence: 99%

Expression profiles of HER2, EGFR, MET and FGFR2 in a large cohort of patients with gastric adenocarcinoma

et al. 2014

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Background Some tyrosine kinase receptors (RTKs) play critical roles in gastric cancer progression. Not only trastuzumab, but also several other agents targeting RTKs are being investigated for gastric cancer therapy. However, the simultaneous expression of multiple RTKs, which may interfere with the effectiveness of therapeutic agents, has not been evaluated in a large cohort with gastric adenocarcinoma (GAC). Methods We performed a tissue microarray analysis in 950 patients with GAC who underwent a gastrectomy without preoperative chemotherapy. The protein expressions of HER2, EGFR, MET and FGFR2 were evaluated using immunohistochemistry, and the gene amplifications of HER2, EGFR and MET were examined using dual-color in situ hybridization.Results The frequency of overexpression was 11.8 % for HER2, 23.5 % for EGFR, 24.9 % for MET and 31.1 % for FGFR2. Whereas strong staining for each of the RTKs was heterogeneous, tumors with homogeneously strong staining areas often exhibited gene amplification. Strong EGFR expression was significantly associated with a poor outcome, but no prognostic correlations were observed in other RTKs. The overexpression of single and multiple RTKs was observed in 40.4 and 22.7 % of the cases, respectively. HER2, EGFR, MET and FGFR2 predominance was observed in 10.1, 13.9, 16.1 and 22.9 % of the GACs, respectively. Conclusions Approximately two-thirds of patients with GAC exhibited the expression of at least one RTK and would be candidates for targeted therapies. Moreover, one-third of at least one RTK overexspressing cases showed multiple RTKs expression. Our results may be useful for selecting the most suitable patients for each targeted therapy.

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Capecitabine and cisplatin with or without cetuximab for patients with previously untreated advanced gastric cancer (EXPAND): a randomised, open-label phase 3 trial

Cited by 734 publications

References 39 publications

Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302)

Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302)

Optimal chemotherapy for advanced gastric cancer: is there a global consensus?

Expression profiles of HER2, EGFR, MET and FGFR2 in a large cohort of patients with gastric adenocarcinoma

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