Phase III randomized study of neoadjuvant chemotherapy (CT) with docetaxel(D), oxaliplatin(O) and S-1(S) (DOS) followed by surgery and adjuvant S-1, vs surgery and adjuvant S-1, for resectable advanced gastric cancer (GC) (PRODIGY)
| Autor: | D.Y. Zang, Jin Young Kim, C.-H. Yoo, Sun Young Rha, Jeong Hwan Yook, Y-K. Kang, Young-Woo Kim, Yeoung-Geol Park, I.-H. Kim, J. Choi, G. Kim, Young-Joon Lee, Min-Hee Ryu, Sang Cheul Oh, In Jae Chung, Sung Hoon Noh |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty business.industry medicine.medical_treatment Hematology medicine.disease Chemotherapy regimen Oxaliplatin Surgery Clinical trial 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Oncology Docetaxel 030220 oncology & carcinogenesis Medicine Gastrectomy Progression-free survival business Neoadjuvant therapy Febrile neutropenia medicine.drug |
| Zdroj: | Annals of Oncology. 30:v876-v877 |
| ISSN: | 0923-7534 0151-5748 |
| DOI: | 10.1093/annonc/mdz394.032 |
| Popis: | Background Adjuvant CT after D2 gastrectomy is standard therapy for resectable advanced GC in Asia. We investigated whether added neoadjuvant (NA) CT can further improve outcomes. Methods 530 pts with newly diagnosed locally advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma (cT2,3/N[+]M0 or cT4/N[any]M0, AJCC 7th ed), ECOG PS 0-1, were randomized 1:1 to NA DOS then surgery and adjuvant S-1 (CSC; n = 266), or surgery and adjuvant S-1 (SC; n = 264). NA CT was D 50mg/m2 iv and O 100mg/m2 iv on day 1, S 40mg/m2 twice po on days 1–14 every 3 weeks for 3 cycles. Standard surgery was D2 gastrectomy. Adjuvant CT was S 40mg/m2 twice po on days 1–28 every 6 weeks for 8 cycles. Primary endpoint: 3-year progression free survival (PFS) in full analysis set (FAS). Results With 46 pts excluded due to ineligibility or consent withdrawal, FAS was 484 pts (238 in CSC, 246 in SC). Baseline characteristics were balanced. In CSC arm, 214 pts (90.0%) completed 3 cycles of NA DOS. Main ≥grade3 toxicities: neutropenia in 12.6%, febrile neutropenia 9.2%, diarrhea in 5.0%, 1 treatment related death. 222 CSC (93.3%) and 246 SC (100%) pts underwent surgery. R0 resection rates: 96.4% vs 85.8%, p Conclusions Addition of NA DOS to D2 gastrectomy and adjuvant S-1 led to significant tumour downstaging and improved PFS with acceptable safety in PRODIGY study. Neoadjuvant DOS chemotherapy followed by D2 gastrectomy and adjuvant S-1 should be considered as a treatment option for resectable advanced GC. Clinical trial identification NCT01515748. Legal entity responsible for the study Sanofi Korea. Funding Sanofi Korea. Disclosure Y. Kang: Advisory / Consultancy: Ono; Advisory / Consultancy: BMS; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Merck Serono; Research grant / Funding (institution): Roche; Advisory / Consultancy, Research grant / Funding (institution): Novartis; Advisory / Consultancy: Daehwa; Advisory / Consultancy: LSKBiopharma; Advisory / Consultancy: Taiho; Advisory / Consultancy: Blueprint; Advisory / Consultancy: Macrogenics; Advisory / Consultancy: Zymeworks; Advisory / Consultancy: Hengrui. G. Kim: Shareholder / Stockholder / Stock options, Full / Part-time employment: Sanofi. Y. Lee: Shareholder / Stockholder / Stock options, Full / Part-time employment: Sanofi. All other authors have declared no conflicts of interest. |
| Databáze: | OpenAIRE |
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