Neo-adjuvant chemotherapy for operable gastric cancer: long term results of the Dutch randomised FAMTX trial

Hartgrink, H.H.; Velde, Cornelis J.H. van de; Putter, Hein; Songun, Ilfet; Tesselaar, Margot E.T.; Kranenbarg, E. Klein; Vries, J.E. de; Wils, J.; Bijl, Jaap van der; Krieken, J.H.J.M. van

doi:10.1016/j.ejso.2004.04.013

Cited by 160 publications

(97 citation statements)

References 32 publications

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“…Controversies remain as to whether perioperative or neoadjuvant chemotherapy improves survival. Although a survival benefit compared with surgery alone has been observed with perioperative epirubicin, cisplatin, and fluorouracil (33), neoadjuvant fluorouracil, doxorubicin, and methotrexate have been shown to be associated with a shorter median survival, although not significantly (34). In those studies, as in the current study, f50% of patients were diagnosed at stage II or stage III.…”

Section: Discussionsupporting

confidence: 64%

Serum Interleukin-6 Level but not Genotype Predicts Survival after Resection in Stages II and III Gastric Carcinoma

Liao¹,

Lin²,

et al. 2008

Clinical Cancer Research

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Purpose: It has been suggested that interleukin-6 (IL-6) is a prognostic indicator for survival in patients with gastric carcinoma, but this has not been proved using survival analysis. In Asians, the -634G allele is associated with increased IL-6 production. The objective of this study was to evaluate the association between serum IL-6 levels, -634G/C polymorphism, and overall survival after resection for gastric carcinoma. Experimental Design: A total of 155 consecutive patients with gastric carcinoma were evaluated. Serum IL-6 levels were analyzed using an enzyme-linked immunoabsorbent assay. Genotype was determined by PCR and restriction fragment length polymorphism. Serum levels and survival were correlated with genotype and clinicopathologic factors. Results: Age and stage, but not -634G/C genotype, were associated with serum IL-6 levels.The median survival for patients with stage II or stage III gastric carcinoma was 1,418 days in patients with low (V13 pg/mL) versus 618 days in patients with high (>13 pg/mL) serum IL-6 levels (P = 0.038). Results of a multivariate analysis showed that serum IL-6 level of >13 pg/mL was a significant predictor of poor survival (hazard ratio, 1.77; 95% confidence interval, 1.07-2.92; P = 0.026).Conclusions: Serum IL-6 level of >13 pg/mL correlates with tumor progression and is an independent predictor of poor survival after resection. In patients with stage II and III gastric carcinoma, serum IL-6 level is more effective than stage as a prognostic indicator. By measuring IL-6, these patients can be divided into two groups with significant differences in survival. The -634G/C polymorphism is not associated with serum IL-6 level or survival.

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Section: Discussionsupporting

confidence: 64%

Serum Interleukin-6 Level but not Genotype Predicts Survival after Resection in Stages II and III Gastric Carcinoma

Liao¹,

Lin²,

et al. 2008

Clinical Cancer Research

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“…A randomized clinical trial coordinated by the Dutch Gastric Cancer Group, compared two groups of patients who underwent surgery alone (n = 30) or received neoadjuvant chemotherapy after surgery (n = 29), i.e., 4 cycles of the FAMTX regimen (5FU, doxorubicin and methotrexate) [24,25] . The R0 resection rates were 62% vs 56% in the surgery alone arm and in the neoadjuvant chemotherapy plus surgery arm, respectively.…”

Section: Neoadjuvant Chemotherapymentioning

confidence: 99%

Neoadjuvant therapy for gastroesophageal adenocarcinoma

Samalin

Ychou

2016

WJCO

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Gastric and esophageal adenocarcinomas are one of the main causes of cancer-related death worldwide. While the incidence of gastric adenocarcinoma is decreasing, the incidence of gastroesophageal junction adenocarcinoma is rising rapidly in Western countries. Considering that surgical resection is currently the major curative treatment, and that the 5-year survival rate highly depends on the pTNM stage at diagnosis, gastroesophageal adenocarcinoma management is very challenging for oncologists. Several treatment strategies are being evaluated, and among them systemic chemotherapy, to decrease recurrences and improve overall survival. The MAGIC and FNCLCC-FFCD trials showed a survival benefit of perioperative chemotherapy in patients with operable gastric and lower esophageal cancer, and these results had an impact on the European clinical practice. New strategies, including induction chemotherapy followed by preoperative chemoradiotherapy, targeted therapies in combination with perioperative chemotherapy and the new cytotoxic regimens, are currently assessed to improve current standards and help developing patienttailored therapeutic interventions. Core tip: Gastric and esophageal adenocarcinomas are one of the main causes of cancer-related death worldwide. The incidence of gastroesophageal junction adenocarcinoma is rapidly rising in Western countries. Surgical resection is currently the major curative treatment. As the 5-year survival rate highly depends on the pTNM stage, the treatment strategy is very challenging for oncologists. Several treatments, including systemic chemotherapy, are being assessed to prevent recurrences and improve overall survival. New strategies, such as induction chemotherapy followed by preoperative chemoradiotherapy, targeted therapies and new cytotoxic regimens in perioperative chemotherapy, are currently assessed to improve current standards and develop more tailored therapeutic interventions.

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“…Previously, the Dutch FAMTX trial (25,54) also had attempted to address this important issue but failed to provide any definitive answer. Similarly, this study was prematurely closed after 59 patients have been enrolled, when an interim analysis showed inadequate rates of curative resection in the chemotherapy group.…”

Section: Neoadjuvant Chemotherapymentioning

confidence: 99%

Perioperative Chemotherapy in Locally Advanced Gastric Cancer

Batista

Santos

Almeida

2013

Arq. Gastroenterol.

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-Gastric cancer is one of the most common cancers and a main cause of cancer-related death worldwide, since the majority of patients suffering of this malignancy are usually faced with a poor prognosis due to diagnosis at later stages. In order to improve treatment outcomes, the association of surgery with chemo and/or radiotherapy (multimodal therapy) has become the standard treatment for locally advanced stages. However, despite several treatment options currently available for management of these tumors, perioperative chemotherapy has been mainly accepted for the comprehensive therapeutic strategy including an appropriated D2-gastrectomy. This manuscript presents a (nonsystematic) critical review about the use of perioperative chemotherapy, with a special focus on the drugs delivery.

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Neo-adjuvant chemotherapy for operable gastric cancer: long term results of the Dutch randomised FAMTX trial

Cited by 160 publications

References 32 publications

Serum Interleukin-6 Level but not Genotype Predicts Survival after Resection in Stages II and III Gastric Carcinoma

Serum Interleukin-6 Level but not Genotype Predicts Survival after Resection in Stages II and III Gastric Carcinoma

Neoadjuvant therapy for gastroesophageal adenocarcinoma

Perioperative Chemotherapy in Locally Advanced Gastric Cancer

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