Neoadjuvant chemotherapy in advanced gastric and esophago-gastric cancer. Meta-analysis of randomized trials

Catena, Fausto; Nardi, M.; Montori, Giulia; Ceresoli, Marco; Celotti, Andrea; Cascinu, Stefano; Fugazzola, Paola; Tomasoni, Matteo; Gléhen, Olivier; Yonemura, Yutaka; Ansaloni, Luca

doi:10.1016/j.ijsu.2018.01.008

Cited by 123 publications

(96 citation statements)

References 22 publications

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“…Combined modality therapy has been shown to significantly increase survival in patients with esophageal or EGJ cancer with locoregional disease compared with resection alone. [50][51][52] Preoperative chemoradiation is the preferred approach for localized resectable disease. 38 Perioperative chemotherapy or preoperative chemotherapy are alternative options for adenocarcinoma of the thoracic esophagus or EGJ.…”

Section: Combined Modality Therapymentioning

confidence: 99%

Esophageal and Esophagogastric Junction Cancers, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology

Ajani

D’Amico

Bentrem

et al. 2019

Journal of the National Comprehensive Cancer Network

802

724

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Esophageal cancer is the sixth leading cause of cancer-related deaths worldwide. Squamous cell carcinoma is the most common histology in Eastern Europe and Asia, and adenocarcinoma is most common in North America and Western Europe. Surgery is a major component of treatment of locally advanced resectable esophageal and esophagogastric junction (EGJ) cancer, and randomized trials have shown that the addition of preoperative chemoradiation or perioperative chemotherapy to surgery significantly improves survival. Targeted therapies including trastuzumab, ramucirumab, and pembrolizumab have produced encouraging results in the treatment of patients with advanced or metastatic disease. Multidisciplinary team management is essential for all patients with esophageal and EGJ cancers. This selection from the NCCN Guidelines for Esophageal and Esophagogastric Junction Cancers focuses on recommendations for the management of locally advanced and metastatic adenocarcinoma of the esophagus and EGJ.

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Section: Combined Modality Therapymentioning

confidence: 99%

Esophageal and Esophagogastric Junction Cancers, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology

Ajani

D’Amico

Bentrem

et al. 2019

Journal of the National Comprehensive Cancer Network

802

724

View full text Add to dashboard Cite

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“…As treatment response is of immense importance for patient's overall outcome, ongoing studies focus on optimizing multimodal treatment concepts with the aim to improve response rates and thereby overall survival [2,3]. It would be of similar importance to improve our ability to predict response rates to multimodal EAC therapy concepts as of today overall response rates to neoadjuvant treatment are only around 50% and a significant number of patients receive neoadjuvant therapy, which is associated with significant toxicity effects without any benefit for non-responder [4].…”

Section: Of 13mentioning

confidence: 99%

Dickkopf-2 (DKK2) as Context Dependent Factor in Patients with Esophageal Adenocarcinoma

Schiffmann

Löser

Jacob

et al. 2020

Cancers

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Dickkopf-2 (DKK2) has been described as Wnt/beta-catenin pathway antagonist and its expression is mediated by micro RNA-221 (miRNA-221). So far, there is only limited data characterizing the role of DKK2 expression in esophageal cancer. A tissue micro array of 192 patients with esophageal adenocarcinoma was analyzed immunohistochemically for DKK2, miRNA-221 expression by RNA scope, and GATA6 amplification by fluorescence in-situ hybridization. The data was correlated with clinical, pathological and molecular data (TP53, HER2, c-myc, GATA6, PIK3CA, and KRAS amplifications). DKK2 expression was detectable in 21.7% and miRNA-221 expression in 33.5% of the patients. We observed no correlation between DKK2 or miRNA-221 expression and clinico-pathological data DKK2 expression was correlated with TP53 mutations and amplification of GATA6. We did not detect a survival difference in dependence of DKK2 for the total cohort, however, in patients without neoadjuvant treatment DKK2 expression correlated with a prolonged survival (median overall-survival 202 vs. 55 months, p = 0.012) which turned opposite in patients that underwent neoadjuvant treatment. High amounts of miRNA-221 were in trend associated with a prolonged overall-survival (p = 0.070). DKK2 as a Wnt antagonist is associated with prolonged survival in patients without neoadjuvant treatment and changes its prognostic value to the contrary in patients after neoadjuvant therapy. The modulatory effects of neoadjuvant treatment in connection with DKK2 expression are not fully understood, but when considering DKK2 as a tumor marker, it is necessary to see it in the context of neoadjuvant therapy.

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“…[5][6][7] To improve patients' survival, a variety of studies have examined the treatment effect of additional chemotherapy and radiotherapy. [8][9][10] Among these, neoadjuvant chemotherapy (or perioperative chemotherapy) was first advocated by Wilke et al 11 It is now widely accepted that neoadjuvant chemotherapy (NAC) can help improve patients' tolerance, increase curative resection rate, decrease tumor metastasis, and thus increase the survival rate. [12][13][14] As a result of its increasing popularity, there is now an increasing need for practical tools to predict individual survival after NAC.…”

Section: Introductionmentioning

confidence: 99%

<p>A Modified ypTNM Staging System–Development and External Validation of a Nomogram Predicting the Overall Survival of Gastric Cancer Patients Received Neoadjuvant Chemotherapy</p>

Xiao

Wang

et al. 2020

CMAR

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These authors contributed equally to this workPurpose: Neoadjuvant chemotherapy is now widely used in gastric cancer patients. However, the current 8th ypTNM staging system is developed based on patients with less extensive lymph node dissection and the predictive value is relatively limited. In this study, we aim to develop and validate a nomogram that predicts overall survival in gastric cancer patients received neoadjuvant chemotherapy. Patients and Methods: From January, 2007 to December, 2014, 471 patients receiving neoadjuvant chemotherapy at our center were enrolled in the study. Based on the Cox proportional hazard model, a nomogram was developed from them and then an external validation was conducted on a cohort of 239 patients from another cancer center. Results: The overall survival (OS) rates of 1 year and 3 years were 90.0% and 64.1%, respectively. Body mass index category, tumor location, T stage and N stage were independent prognostic factors for the survival outcome. The C-index of the model was 0.74 in the development cohort and 0.69 in the validation cohort. Our nomogram also showed good calibration in both cohorts. Conclusion: We developed and validated a nomogram to predict the 1-and 3-year OS of patients who received neoadjuvant chemotherapy and radical gastrectomy with D2 lymph node dissection. This nomogram predicts survival more accurately than the AJCC TNM staging system, which is the current golden standard.

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Neoadjuvant chemotherapy in advanced gastric and esophago-gastric cancer. Meta-analysis of randomized trials

Cited by 123 publications

References 22 publications

Esophageal and Esophagogastric Junction Cancers, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology

Esophageal and Esophagogastric Junction Cancers, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology

Dickkopf-2 (DKK2) as Context Dependent Factor in Patients with Esophageal Adenocarcinoma

<p>A Modified ypTNM Staging System–Development and External Validation of a Nomogram Predicting the Overall Survival of Gastric Cancer Patients Received Neoadjuvant Chemotherapy</p>

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