Early tumor shrinkage and depth of response in patients with advanced gastric cancer: a retrospective analysis of a randomized phase III study of first-line S-1 plus oxaliplatin vs. S-1 plus cisplatin

Nishina, Tomohiro; Azuma, Mizutomo; Nishikawa, Kazuhiro; Gotoh, Masahiro; Bando, Hideaki; Sugimoto, Naotoshi; Amagai, Kenji; Chìn, Keisho; Niwa, Yasumasa; Tsuji, Akihito; Imamura, Hiroshi; Tsuda, Masahiro; Yasui, Hirofumi; Fujii, Hirofumi; Yamaguchi, Kensei; Yasui, Hisateru; Hironaka, Shuichi; Shimada, Ken; Miwa, Hiroto; Mitome, Terukazu; Kageyama, Hiroki; Hyodo, Ichinosuke

doi:10.1007/s10120-018-0845-7

Cited by 11 publications

(5 citation statements)

References 18 publications

(36 reference statements)

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“…The relationship between DpR and prognosis was analyzed. The results showed that DpR was correlated with PFS and OS ( 64 ), which was different from the results of Osumi et al ’s.…”

Section: Application Of Dpr In Gastric Cancercontrasting

confidence: 81%

A narrative review: depth of response as a predictor of the long-term outcomes for solid tumors

Xie¹,

Li²,

Yao³

2021

Transl Cancer Res TCR

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Response Evaluation Criteria in Solid Tumors (RECIST 1.1) is classical and popular for public. However, there are some problems recently. For example, partial response ranges from 30% to 99%, objective response is dichotomous, so there may be some heterogeneity. New metrics for evaluating the efficacy have been investigating, such as early tumor shrinkage, time to response and depth of response (DpR). DpR has been used in hematologic malignancies and is considered as a predictor of efficiency. In solid tumors, DpR was firstly proposed by Mansmann et al. in metastatic colorectal cancer (mCRC) and defined as the percentage of tumor shrinkage, which is a continuous metric, and could avoid the information loss due to dichotomization of responses that has been widely applied to several kinds of solid tumors. Some authors have found associations between DpR and OS, DpR is a valuable surrogate endpoint for mCRC, metastatic breast cancer, metastatic melanoma and advanced pancreatic cancer. However, the predictive value of DpR is still uncertain in the research of lung cancer and gastric cancer. Which indicating that a mature and unified application standard has not yet been formed for DpR. This article summarizes researches on the DpR as a predictor of the long-term outcomes for solid tumors, it also discusses the challenges and limitations in the applications of DpR.

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“…The relationship between DpR and prognosis was analyzed. The results showed that DpR was correlated with PFS and OS ( 64 ), which was different from the results of Osumi et al ’s.…”

Section: Application Of Dpr In Gastric Cancercontrasting

confidence: 81%

A narrative review: depth of response as a predictor of the long-term outcomes for solid tumors

Xie¹,

Li²,

Yao³

2021

Transl Cancer Res TCR

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“…S-1 is an oral fluoropyrimidine composed of 3 pharmacological compounds, including tegafur, gimeracil, and oteracil potassium, at a molar ratio of 1:0.4:1, and it has been widely used among Asian patients with advanced gastric cancer (aGC), breast cancer, and pancreatic carcinoma. [6–8] However, insufficient positive evidence has been obtained to establish its therapeutic value in patients with colorectal cancer. A large-scaled, open-label, non-inferiority, randomized, phase 3, multicentre trial (JCOG0910) explore the non-inferiority of S-1 compared with capecitabine as adjuvant treatment in patients with stage III colorectal cancer, and 3-year disease-free survival was 82.0% (95% confidence interval [CI]: 78.5–85.0) for the capecitabine group and 77.9% (95% CI: 74.1–81.1) for the S-1 group (hazard ratio [HR], 1.23, 99.05% CI: 0.89–1.70; 1-sided P non-inferiority = .46).…”

Section: Introductionmentioning

confidence: 99%

Comparison of efficacy and safety of S-1 and capecitabine in patients with metastatic colorectal carcinoma

Chen¹,

Wang²,

2019

Medicine

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Background: This study aimed to compare the efficacy and safety of S-1 and capecitabine in patients with metastatic colorectal carcinoma (mCRC). Methods: Eligible prospective clinical trials were searched and available data were extracted. Odds ratio and hazard ratio of available outcomes including objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were pooled for analysis. Results: A total of 6 studies including 828 patients were included. The results of pooled analysis showed no statistical difference in short-term efficacy including ORR (95% confidence interval [CI]: 0.68–1.19; P = .48) or DCR (95% CI: 0.65–1.29; P = .61), or long-term efficacy including PFS (95% CI: 0.75–1.08; P = .26) or OS (95% CI: 0.78–1.13; P = .50). Symptoms of diarrhea at any grade were more prevalent (95% CI: 1.21–2.29; P = .002) in patients treated with S-1, while hand-foot syndrome (HFS) at any grade (95% CI: 0.24–0.48; P < .0001) or high grade (95% CI: 0.09–0.48; P < .0001) was more frequent in capecitabine group. AEs including leucopenia, neutropenia, anemia, thrombocytopenia, vomiting, oral mucositis, stomatitis, elevated alanine transaminase, or peripheral neuropathy showed no statistical difference between S-1 and capecitabine group (all P > .05). Conclusions: This meta-analysis reveals that S-1 has comparable efficacy, lower risk of HFS and higher incidence of diarrhea compared to capecitabine for treatment in patients with mCRC.

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“…For these reasons, we first selected chemotherapy with SOX plus bevacizumab to shrink both tumors and to control the micrometastases. SOX has been shown to be effective for gastric cancer [13,14], and SOX plus bevacizumab has been shown to be effective for metastatic colorectal cancer [15]. Therefore, we selected the SOX plus bevacizumab regimen for this patient.…”

Section: Discussionmentioning

confidence: 99%

Multiple liver metastases with synchronous gastric and transverse colon cancer diagnosed by gastric perforation successfully treated by SOX plus bevacizumab and completely resected by surgery: a case report

et al. 2020

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Background: Synchronous double cancer of the colon and stomach accompanied by liver metastasis is rare. It is often difficult to determine an appropriate treatment strategy for multiple liver metastases of synchronous gastric cancer and colorectal cancer. Multidisciplinary treatment is required based on the progression and location of each tumor and chemotherapy for complete resection. Case presentation: A 57-year-old male who complained of acute abdominal pain and fever visited his local hospital. He underwent emergent surgery for peritonitis caused by a gastric perforation. The cytodiagnosis of ascites did not show any tumor cells. There was a liver metastasis in the lateral segment of the liver. We performed a primary closure of the defect and then applied an omentum flap. After surgery, the patient was diagnosed as having synchronous cStage IV transverse colon cancer with multiple liver metastases and cStage IIB gastric cancer. The [18F]-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) showed 18F-FDG uptake by the colon tumor and multiple liver metastases, but there was no uptake in the gastric tumor or lymph nodes. We retrospectively reevaluated the CT findings from a local hospital and detected a liver nodule in segment 2/3 (from 35 to 60 mm) and segment 6 (from 26 to 57 mm), and the tumors had dramatically grown in size in only 2 months. Because complete tumor resection would be difficult, S-1 and oxaliplatin (SOX) plus bevacizumab therapy was started to control tumor progression. After 20 courses of chemotherapy, the clinical diagnosis was ycStage IV transverse colon cancer and ycStage IIa gastric cancer. We planned a two-step procedure to completely resect the primary tumors and multiple liver metastases. We first performed a laparoscopic rightcolon resection+D3 lymphadenectomy and open distal gastrectomy+D2 lymphadenectomy. The patient was discharged home on postoperative day 18. After 1 month, we performed open liver resection. The pathological findings showed that the transverse colon was ypT2 (MP) with grade 2 therapeutic effects and that there were no atypical cells in the gastric tumor and multiple liver nodules (pathological complete response).

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Early tumor shrinkage and depth of response in patients with advanced gastric cancer: a retrospective analysis of a randomized phase III study of first-line S-1 plus oxaliplatin vs. S-1 plus cisplatin

Abstract: In AGC patients receiving the first-line therapy, ETS and DpR might be predictors for PFS and OS.

Cited by 11 publications

References 18 publications

A narrative review: depth of response as a predictor of the long-term outcomes for solid tumors

A narrative review: depth of response as a predictor of the long-term outcomes for solid tumors

Comparison of efficacy and safety of S-1 and capecitabine in patients with metastatic colorectal carcinoma

Multiple liver metastases with synchronous gastric and transverse colon cancer diagnosed by gastric perforation successfully treated by SOX plus bevacizumab and completely resected by surgery: a case report

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