BACKGROUND: Although the role of peri-operative chemotherapy is established in the treatment of locally advanced gastric cancer, the optimal regime remains to be determined. FOLFOX has been used in palliative setting with good response rates but its role in a neoadjuvant setting is not well established. METHODS: This is a prospective non-randomized study comparing peri-operative FOLFOX versus adjuvant FOLFOX in patients with resectable locally advanced gastric cancer. Response to chemotherapy was assessed according to WHO criteria and pathological changes. Kaplan-Meier log rank test was used to calculate and compare survival differences. RESULTS: There were 73 patients (neoadjuvant = 36). Complete and partial response was observed in 2 (6%) and 21 (64%) patients, respectively. Four-year overall survival (OS) in the neoadjuvant arm was 78% versus 51% in the adjuvant arm (P = 0.031). Subgroup analysis found R0 resection (86% vs. 55%, P = 0.011) and patients with proximal cancers (87% vs. 14%, P < 0.001) to have improved OS. The most common side effect was grade 1-2 leukopenia. There were no grade 3 neuropathies, grade 4 cytopaenias, or treatment related deaths. CONCLUSION: Peri-operative treatment with FOLFOX shows promise in patients with resectable locally advanced gastric cancer. It warrants further evaluation and should be considered an alternative to peri-operative ECF.
BACKGROUND: Although the role of peri-operative chemotherapy is established in the treatment of locally advanced gastric cancer, the optimal regime remains to be determined. FOLFOX has been used in palliative setting with good response rates but its role in a neoadjuvant setting is not well established. METHODS: This is a prospective non-randomized study comparing peri-operative FOLFOX versus adjuvant FOLFOX in patients with resectable locally advanced gastric cancer. Response to chemotherapy was assessed according to WHO criteria and pathological changes. Kaplan-Meier log rank test was used to calculate and compare survival differences. RESULTS: There were 73 patients (neoadjuvant = 36). Complete and partial response was observed in 2 (6%) and 21 (64%) patients, respectively. Four-year overall survival (OS) in the neoadjuvant arm was 78% versus 51% in the adjuvant arm (P = 0.031). Subgroup analysis found R0 resection (86% vs. 55%, P = 0.011) and patients with proximal cancers (87% vs. 14%, P < 0.001) to have improved OS. The most common side effect was grade 1-2 leukopenia. There were no grade 3 neuropathies, grade 4 cytopaenias, or treatment related deaths. CONCLUSION: Peri-operative treatment with FOLFOX shows promise in patients with resectable locally advanced gastric cancer. It warrants further evaluation and should be considered an alternative to peri-operative ECF.
Authors: Ninu Maskey; Kai Li; Min Hu; Zhigao Xu; Chunwei Peng; Fang Yu; Hong Cao; Jiamei Chen; Yan Li; Guifang Yang Journal: Tumour Biol Date: 2014-09-27
Authors: Joanna Gotfrit; Rachel Goodwin; Timothy Asmis; Angela J Hyde; Thierry Alcindor; Francine Aubin; Scott Berry; Dominick Bossé; Colin Brown; Ronald Burkes; Margot Burnell; Bruce Colwell; Jessica Corbett; Jeff Craswell; Nathalie Daaboul; Mark Doherty; D A Barry Fleming; Luisa Galvis; Rakesh Goel; Mohammed Harb; Alwin Jeyakumar; Derek Jonker; Erin Kennedy; Michael Lock; Aamer Mahmud; Patrick H McCrea; Vimoj Nair; Rami Nassabein; Carolyn Nessim; Ravi Ramjeesingh; Muhammad Raza; Wissam Saliba; Satareh Samimi; Simron Singh; Stephanie Snow; Mustapha Tehfé; Michael Thirlwell; Mario Valdes; Stephen Welch; Michael Vickers Journal: Curr Oncol Date: 2021-05-26 Impact factor: 3.677