Perioperative chemotherapy with docetaxel plus oxaliplatin and S-1 (DOS) versus oxaliplatin plus S-1 (SOX) for the treatment of locally advanced gastric or gastro-esophageal junction adenocarcinoma (MATCH): an open-label, randomized, phase 2 clinical trial.

IF 6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Gastric Cancer Pub Date : 2024-05-01 Epub Date: 2024-03-08 DOI:10.1007/s10120-024-01471-z
Zhichao Jiang, Yibin Xie, Wen Zhang, Chunxia Du, Yuxin Zhong, Yuelu Zhu, Liming Jiang, Lizhou Dou, Kang Shao, Yongkun Sun, Qi Xue, Yantao Tian, Shugeng Gao, Dongbing Zhao, Aiping Zhou
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引用次数: 0

Abstract

Background: It remains unclear whether addition of docetaxel to the combination of a platinum and fluoropyrimidine could provide more clinical benefits than doublet chemotherapies in the perioperative treatment for locally advanced gastric/gastro-esophageal junction (LAG/GEJ) cancer in Asia. In this randomized, phase 2 study, we assessed the efficacy and safety of perioperative docetaxel plus oxaliplatin and S-1 (DOS) versus oxaliplatin plus S-1 (SOX) in LAG/GEJ adenocarcinoma patients.

Methods: Patients with cT3-4 Nany M0 G/GEJ adenocarcinoma were randomized (1:1) to receive 4 cycles of preoperative DOS or SOX followed by D2 gastrectomy and another 4 cycles of postoperative chemotherapy. The primary endpoint was major pathological response (MPR).

Results: From Aug, 2015 to Dec, 2019,154 patients were enrolled and 147 patients included in final analysis, with a median age of 60 (26-73) years. DOS resulted in significantly higher MPR (25.4 vs. 11.8%, P = 0.04). R0 resection rate, the 3-year PFS and 3-year OS rates were 78.9 vs. 61.8% (P = 0.02), 52.3 vs. 35% (HR 0.667, 95% CI: 0.432-1.029, Log rank P = 0.07) and 57.5 vs. 49.2% (HR 0.685, 95% CI: 0.429-1.095, Log rank P = 0.11) in the DOS and SOX groups, respectively. Patients who acquired MPR experienced significantly better survival. DOS had similar tolerance to SOX.

Conclusions: Perioperative DOS improved MPR significantly and tended to produce longer PFS compared to SOX in LAG/GEJ cancer in Asia, and might be considered as a preferred option for perioperative chemotherapy and worth further investigation.

Abstract Image

多西他赛+奥沙利铂和S-1(DOS)与奥沙利铂+S-1(SOX)围术期化疗治疗局部晚期胃癌或胃食管交界处腺癌(MATCH):一项开放标签、随机、2 期临床试验。
背景:在亚洲,在局部晚期胃癌/胃食管交界处癌(LAG/GEJ)围手术期治疗中,在铂类和氟嘧啶类药物的组合中添加多西他赛是否能比双药化疗带来更多临床益处,目前仍不清楚。在这项随机2期研究中,我们评估了多西他赛+奥沙利铂和S-1(DOS)与奥沙利铂+S-1(SOX)在LAG/GEJ腺癌患者围手术期的疗效和安全性:cT3-4 Nany M0 G/GEJ腺癌患者随机(1:1)接受4个周期的术前DOS或SOX治疗,然后进行D2胃切除术和4个周期的术后化疗。主要终点为主要病理反应(MPR):2015年8月至2019年12月,154名患者入组,147名患者纳入最终分析,中位年龄为60(26-73)岁。DOS导致的MPR明显更高(25.4% vs. 11.8%,P = 0.04)。DOS组和SOX组的R0切除率、3年PFS和3年OS率分别为78.9% vs. 61.8%(P = 0.02)、52.3% vs. 35%(HR 0.667,95% CI:0.432-1.029,Log rank P = 0.07)和57.5% vs. 49.2%(HR 0.685,95% CI:0.429-1.095,Log rank P = 0.11)。获得 MPR 的患者生存率明显更高。DOS与SOX的耐受性相似:亚洲 LAG/GEJ 癌患者围手术期 DOS 能明显改善 MPR,与 SOX 相比,DOS 往往能延长 PFS,可作为围手术期化疗的首选方案,值得进一步研究。
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来源期刊
Gastric Cancer
Gastric Cancer 医学-胃肠肝病学
CiteScore
14.70
自引率
2.70%
发文量
80
审稿时长
6-12 weeks
期刊介绍: Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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