The predictors of response to neoadjuvant chemotherapy in patients with locally advanced gastric cancer

Qu, Jianjun; Qu, Xiangyang

doi:10.3233/cbm-160616

Cited by 17 publications

(20 citation statements)

References 13 publications

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“…The authors believe that NACT and indeed multimodality therapy need to be tailored and individualised for gastric cancers. Recent advances in biomarkers predicting chemotherapy response (HER2, P53) show promising results and will be useful to tailor NACT for gastric carcinoma based on the profile of each patient [ 23 ]. Newer biomarkers like angiopoietin-2 show promising results for targeted therapy in gastric cancers as well [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Radical Gastrectomy: Still the Cornerstone of Curative Treatment for Gastric Cancer in the Perioperative Chemotherapy Era—A Single Institute Experience over a Decade

Kanhere

Goel

Finlay

et al. 2018

International Journal of Surgical Oncology

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Background and Objectives Most gastric cancer patients now undergo perioperative chemotherapy (POCT) based on the MAGIC trial results. POCT consists of neoadjuvant chemotherapy (NACT) as well as postoperative adjuvant chemotherapy. This study assessed the applicability of perioperative chemotherapy and the impact of radical gastrectomy encompassing a detailed lymph-node resection on outcomes of gastric cancer. Methods Medical and pathology records of all gastric carcinoma resections were reviewed from 2006 onwards. Pathological details, number of lymph-nodes resected, and proportion of involved nodes, reasons for nonadministration of NACT, complications, recurrence, and survival data were analysed. Results Only twenty-eight (37.8%) out of 74 patients underwent NACT and only nine completed POCT. NACT was declined due to comorbidities/patient refusal n = 24, early stage n = 14, and emergency presentation n = 8. Patients receiving NACT were much younger. Anastomotic leaks, hospital-mortality, lymph-node yield, and proportion of involved lymph-nodes were similar in both groups. Thirty-two patients died due to recurrence with lymph-node involvement heralding higher recurrence risk and much poorer survival (HR 2.66; p = 0.013). Conclusion More than 60% patients with resectable gastric carcinoma did not undergo NACT. Radical gastrectomy with lymphadenectomy remained the cornerstone of treatment in this period.

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Section: Discussionmentioning

confidence: 99%

Radical Gastrectomy: Still the Cornerstone of Curative Treatment for Gastric Cancer in the Perioperative Chemotherapy Era—A Single Institute Experience over a Decade

Kanhere

Goel

Finlay

et al. 2018

International Journal of Surgical Oncology

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“…[ 18 ] Therefore, neoadjuvant chemotherapy is frequently used to downstage tumors and to increase the resection rate. [ 19 20 ]…”

Section: Introductionmentioning

confidence: 99%

Patients Administered Neoadjuvant Chemotherapy Could be Enrolled into an Enhanced Recovery after Surgery Program for Locally Advanced Gastric Cancer

Zhao

Wang

Jiang

et al. 2018

Chinese Medical Journal

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Background:Most studies on enhanced recovery after surgery (ERAS) for gastric cancer exclude patients who received neoadjuvant chemotherapy. Here, we aimed to evaluate whether patients who received neoadjuvant chemotherapy can be enrolled into the ERAS program for locally advanced gastric cancer.Methods:From April 2015 to July 2017, 114 patients who received neoadjuvant chemotherapy for locally advanced gastric cancer were randomized into ERAS and standard care (SC) groups. Postoperative length of stay, complications, bowel function, and nutritional status were recorded.Results:The postoperative length of stay of the ERAS group was shorter compared with that of the SC group (5.9 ± 5.6 vs. 8.1 ± 5.3 days, P = 0.037). The postoperative complication rate was 9.3% in the ERAS group and 11.5% in the SC group (P = 0.700). The time to first flatus (2.7 ± 2.0 vs. 4.5 ± 4.6 days, P = 0.010) and time to a semi-liquid diet (3.2 ± 2.1 vs. 6.3 ± 4.9 days, P < 0.001) in the ERAS group were shorter compared with those in the SC group. On the 10th day after surgery, the values of weight, total protein, albumin, and prealbumin of the ERAS group were lower compared with those of the SC group.Conclusions:Patients who received neoadjuvant chemotherapy could be enrolled into ERAS programs for locally advanced gastric cancer. The nutritional status of these patients was not adversely affected.

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“…Above all, the level of 15-PGDH, infiltration of Foxp3 Tregs, dendritic cell density, and low B7-H4 expression served as useful prognostic biomarkers/predictors for ADC treated with FOLFOX6 regimen preoperatively. Qu et al [37] conducted a clinical study to investigate whether the seven GC-related biomarkers served as predictors to preoperative chemotherapy. Using a preoperative chemotherapy regimen of mFOLFOX7, which was very similar to FOLFOX6, the expression of C-met, EGFR, HER2, Ki-67, MMP7, P53, and TOPII was tested in GC tissues before and after mFOLFOX7 preoperative chemotherapy.…”

Section: Preoperative Chemotherapy and Precision Medicinementioning

confidence: 99%

Preoperative Chemotherapy for Gastric Cancer: Personal Interventions and Precision Medicine

Beeharry

et al. 2016

BioMed Research International

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In spite of the declining incidence of gastric cancer (GC) in recent years, the mortality rate is still high. The asymptomatic nature and nonspecific clinical manifestations combined with the lack of efficient screening programs delay the diagnosis of GC. Therefore, the prevalence of advanced gastric cancer (AGC) has prompted the need for aggressive and intensive treatment options. Among the various treatment options for AGC, surgery is still the mainstay. However, the efficacy of surgery alone is not established. Results from multiple randomized controlled trials suggest that preoperative chemotherapy is promising intervention for the treatment and management of AGC. The main objective of neoadjuvant chemotherapy is to downstage or control micrometastasis in resectable tumor before surgery. On the other hand, conversion chemotherapy refers to surgical treatment aiming at R0 resection after chemotherapy for originally nonresectable or marginally resectable tumors. Nevertheless, preoperative chemoradiotherapy is considered beneficial for AGC patients. Over the last few decades, the combination of chemotherapy and targeted therapy prior to surgery demonstrated great results for the treatment of AGC. The rapid developments in genomics and proteomics have heralded the era of precision medicine. The combination of preoperative chemotherapy and precision medicine may enhance survival in AGC patients.

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The predictors of response to neoadjuvant chemotherapy in patients with locally advanced gastric cancer

Abstract: HER2 and P53 were identified as independent predictors for the response to mFOLFOX7 NACT in AGC.

Cited by 17 publications

References 13 publications

Radical Gastrectomy: Still the Cornerstone of Curative Treatment for Gastric Cancer in the Perioperative Chemotherapy Era—A Single Institute Experience over a Decade

Radical Gastrectomy: Still the Cornerstone of Curative Treatment for Gastric Cancer in the Perioperative Chemotherapy Era—A Single Institute Experience over a Decade

Patients Administered Neoadjuvant Chemotherapy Could be Enrolled into an Enhanced Recovery after Surgery Program for Locally Advanced Gastric Cancer

Preoperative Chemotherapy for Gastric Cancer: Personal Interventions and Precision Medicine

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