Gastric Cancer最新文献

{"title":"Heterogeneity of predictive biomarker expression in gastric and esophago-gastric junction carcinoma with peritoneal dissemination.","authors":"Valentina Angerilli, Matilde Callegarin, Ilaria Govoni, Giuseppe De Lisi, Michele Paudice, Paola Fugazzola, Alessandro Vanoli, Paola Parente, Francesca Bergamo, Claudio Luchini, Angelo Paolo Dei Tos, Federica Grillo, Sara Lonardi, Luca Mastracci, Gaya Spolverato, Matteo Fassan","doi":"10.1007/s10120-025-01609-7","DOIUrl":"10.1007/s10120-025-01609-7","url":null,"abstract":"<p><strong>Background: </strong>Temporal and spatial molecular heterogeneity contributes to resistance to targeted and immune therapies in gastric and esophagogastric junction carcinoma (G/EGJ). This study evaluates differences in biomarker expression between primary G/EGJ and paired peritoneal metastases (PM).</p><p><strong>Methods: </strong>We analyzed 74 cases of primary G/EGJ and paired PM using immunohistochemistry for HER2, PD-L1, Claudin18 (CLDN18), DNA mismatch repair (MMR) proteins, p53, E-cadherin, and in situ hybridization for EBER. Biomarker concordance between primary and metastatic tumors was assessed.</p><p><strong>Results: </strong>Primary G/EGJ were predominantly poorly cohesive (45.9%) or mixed-type (37.8%). Regarding predictive biomarkers, low rates of HER2 overexpression (5.4%), MMR deficiency (4.1%), and EBER positivity (1.4%) were observed, while PD-L1 CPS ≥ 1 occurred in 79.7% of cases and CLDN18 positivity was observed in 31.1% of cases. Concordance was perfect for MMR and EBER, while PD-L1 showed the highest discordance (32.4%). HER2 had a low discordance rate (2.7%). CLDN18 exhibited good concordance (86.5%) and showed consistent positivity in PD-L1- and HER2-negative primary tumors (28.6%).</p><p><strong>Conclusion: </strong>G/EGJ with PM show distinct molecular features and spatial heterogeneity, with MMR, EBER, and HER2 demonstrating strong concordance, while PD-L1 showed greater variability. As for novel biomarkers, CLDN18.2 shows substantial concordance between primary G/EGJ and PM and could be a promising target in HER2/PD-L1-negative G/EGJ with PM.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"569-578"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of EBV-positivity in patients with gastric cancer treated with first-line nivolumab plus chemotherapy.","authors":"Hyung-Don Kim, So-Yeon Kim, Hyungeun Lee, Yuna Lee, Jaewon Hyung, Meesun Moon, Jinho Shin, Young Soo Park, Min-Hee Ryu","doi":"10.1007/s10120-025-01618-6","DOIUrl":"10.1007/s10120-025-01618-6","url":null,"abstract":"<p><strong>Background: </strong>Epstein-Barr virus (EBV) positivity is a potential predictive biomarker for immune checkpoint inhibitors (ICIs) in gastric cancer patients, but its value in first-line ICI-based chemotherapy remains unclear. This study aimed to evaluate the predictive value of EBV positivity in patients treated with first-line nivolumab plus chemotherapy.</p><p><strong>Methods: </strong>This single-center study included advanced gastric cancer patients treated with first-line nivolumab plus chemotherapy (n = 293). Patients with EBV positivity treated with chemotherapy alone (n = 12) served as the control group. EBV positivity was confirmed by in situ hybridization.</p><p><strong>Results: </strong>Among patients treated with nivolumab plus chemotherapy, 18 (6.1%) had EBV-positive tumors, and these were associated with high PD-L1 combined positive score (CPS) expression levels. Progression-free survival (PFS) and overall survival (OS) tended to be more favorable in those with EBV-positive tumors. Multivariate analysis of patients treated with nivolumab-chemotherapy revealed that EBV positivity, combined with PD-L1 CPS ≥ 5, was an independent factor for PFS. In patients with EBV-positive tumors, nivolumab-chemotherapy was associated with significantly favorable PFS and OS compared to chemotherapy alone. Similar results were observed in the subgroup with PD-L1 CPS ≥ 5. However, survival outcomes did not differ between patients treated with nivolumab plus chemotherapy versus chemotherapy alone in the subgroup with PD-L1 CPS < 5.</p><p><strong>Conclusion: </strong>EBV positivity predicts favorable survival outcomes in patients with gastric cancer treated with nivolumab plus chemotherapy. The benefit of nivolumab plus chemotherapy over chemotherapy alone for patients with EBV positivity appears to be associated with high PD-L1 expression levels.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"631-640"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low positivity rate of fibroblast growth factor receptor 2b is associated with heterogeneous expression in gastric cancer.","authors":"Heonwoo Lee, Min-Hee Ryu, In-Seob Lee, Ji Yong Ahn, Jeong Hoon Lee, Hyungeun Lee, Hyung-Don Kim, Young Soo Park","doi":"10.1007/s10120-025-01611-z","DOIUrl":"10.1007/s10120-025-01611-z","url":null,"abstract":"<p><strong>Background: </strong>Bemarituzumab, a monoclonal antibody targeting fibroblast growth factor receptor 2b (FGFR2b), is under evaluation in phase 3 trials of gastric cancer (GC) trials. However, data on the characteristics, prognostic significance, and heterogenous expression patterns of FGFR2b overexpression in GC remain limited. Therefore, this study aims to investigate the clinicopathologic characteristics and survival outcomes of FGFR2b-positive GC, along with the expression concordance across biopsy, surgical, and metastatic specimens.</p><p><strong>Methods: </strong>This retrospective study included 466 patients with stages I-IV GC. Biopsy-surgical and primary-metastatic specimen pairs were available for 163 and 135 patients, respectively. FGFR2b overexpression was defined as moderate-to-strong membranous and/or cytoplasmic expression in ≥ 10% of tumor cells. FGFR2 amplification was evaluated using chromogenic in situ hybridization.</p><p><strong>Results: </strong>FGFR2b overexpression was observed in 4.1% of patients, with 14/341 surgical specimens (4.1%), 3/284 gastric biopsies (1.1%), and 4/135 metastatic specimens (3.0%). FGFR2b overexpression correlated with deeper invasion and perineural invasion in resectable GC. However, it did not influence survival outcomes in resectable or metastatic GC. Among 163 biopsy-surgical pairs, FGFR2b overexpression was observed in only one pair (0.6%). Similarly, among 135 paired primary-metastatic specimens, FGFR2b overexpression was observed in one (0.7%). FGFR2 gene amplification occurred in 16/17 (94.1%) cases with FGFR2b overexpression.</p><p><strong>Conclusion: </strong>Significant intratumoral and intrapatient heterogeneity is observed in FGFR2b overexpression. Given this variability in expression levels, a single endoscopic biopsy may not accurately assess FGFR2b overexpression. The FGFR2b positivity rate in gastric cancers was 4.1%, likely due to the substantial heterogeneity in its expression.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"598-608"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant docetaxel, oxaliplatin, and S-1 therapy for patients with large type 3 or type 4 gastric cancer: short-term outcomes of a multicenter, phase II study (OGSG1902).","authors":"Ryo Tanaka, Shunji Endo, Toshifumi Yamaguchi, Hiromichi Miyagaki, Junji Kawada, Takeshi Omori, Naoki Takahashi, Toru Masuzawa, Haruna Furukawa, Yuya Sato, Atsushi Takeno, Naoki Shinno, Ryohei Kawabata, Shinsuke Katsuyama, Shigeyoshi Higashi, Yukinori Kurokawa, Toshimasa Tsujinaka, Toshio Shimokawa, Taroh Satoh","doi":"10.1007/s10120-025-01608-8","DOIUrl":"10.1007/s10120-025-01608-8","url":null,"abstract":"<p><strong>Background: </strong>Large type 3 (≥ 8 cm) and type 4 gastric cancers (GCs) have poor prognoses and necessitate multidisciplinary treatment. A multi-institutional phase II study (OGSG1902) was conducted to assess the efficacy and safety of neoadjuvant chemotherapy (NAC) with docetaxel, oxaliplatin, and S-1 (DOS) in these patients.</p><p><strong>Methods: </strong>Patients with large type 3 or type 4 GC without distant metastasis, except for positive peritoneal cytology (CY), were enrolled. Patients received three courses of neoadjuvant DOS therapy (docetaxel 40 mg/m² and oxaliplatin 100 mg/m² on day 1 via intravenous infusion, and S-1 80 mg/m² orally for 14 days, repeated every 3 weeks) followed by gastrectomy. After R0 resection, adjuvant docetaxel/S-1 therapy was administered for 1 year.</p><p><strong>Results: </strong>From October 2019 to February 2022, 48 patients were enrolled. NAC was completed in 91.7% of patients. The R0 resection rate was 89.6%. The pathological response rate (Grade 1b-3) was 66.7%. Among patients with measurable lesions, the response rate was 50.0%. The CY-negative conversion rate was 80.0%, and the protocol completion rate was 45.8%. Grade 3 or 4 adverse events during NAC, including neutropenia and appetite loss, occurred in 37.5% of patients. Major postoperative complications (Clavien-Dindo Grade IIIa or higher) were observed in 2.1% of patients.</p><p><strong>Conclusions: </strong>NAC with DOS for large type 3 or type 4 GC followed by gastrectomy demonstrated promising efficacy, high pathological response rates, and an acceptable toxicity profile. Further evaluation of long-term survival outcomes is ongoing.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"662-672"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korea, Japan, Europe, and the United States: Why are guidelines for gastric cancer different?","authors":"Emily E Stroobant, Seong-Ho Kong, Maria Bencivenga, Takahiro Kinoshita, Tae-Han Kim, Takeshi Sano, Giovanni de Manzoni, Han-Kwang Yang, Yuko Kitagawa, Vivian E Strong","doi":"10.1007/s10120-025-01613-x","DOIUrl":"10.1007/s10120-025-01613-x","url":null,"abstract":"<p><p>As a global health concern, gastric cancer management has been systematized by individual countries and regions into regimented guidelines. To explore international differences, we examined the guidelines of Korea, Japan, Europe, and the United States. Guidelines are created by experts in the field, focusing on evidence-based recommendations to standardize and improve patient care, but the methodology for guideline creation, incorporation of new innovations, and review differs significantly. National and regional differences within the guidelines are apparent, stemming from various factors including local incidence, stage, presentation, patient preferences, and governmental influences. Differences include the use of neoadjuvant chemotherapy, criteria for endoscopic resection, and extent of lymphadenectomy. Nonetheless, fundamental treatment principles remain universal, and the goals of national guidelines are uniform: standardizing patient care, providing the highest quality treatments, incorporating cutting-edge clinical trial results, and consensus in guidelines to help formulate governmental policies. This review highlights how the guidelines are constructed, the unique elements of each guideline, how they differ, and why they differ.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"559-568"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pairwise analysis of plasma cell-free DNA before and after palliative second-line paclitaxel plus ramucirumab treatment in patients with metastatic gastric cancer.","authors":"Ji-Won Kim, Dong Soo Kyung, Won Yeong Ko, Hwang-Phill Kim, Sung-Hyun Hwang, Kui-Jin Kim, Ju Hyun Lee, Jeongmin Seo, Minsu Kang, Eun Hee Jung, Koung Jin Suh, Se Hyun Kim, Jin Won Kim, Yu Jung Kim, Jee Hyun Kim, Keun-Wook Lee","doi":"10.1007/s10120-025-01604-y","DOIUrl":"10.1007/s10120-025-01604-y","url":null,"abstract":"<p><strong>Background: </strong>This study compared plasma cell-free DNA (cfDNA) and tumor tissue DNA (ttDNA) to explore the clinical applicability of cfDNA in patients with metastatic gastric cancer (mGC) receiving palliative second-line paclitaxel + ramucirumab treatment.</p><p><strong>Methods: </strong>Targeted sequencing of 106 genes was conducted using germline DNA and cfDNA at baseline (baseline-cfDNA) and progressive disease (PD-cfDNA). The results were compared with those of ttDNA-based cancer panel data.</p><p><strong>Results: </strong>Of 76 consecutive patients, 46 (27 males; median age 57.5 [range, 32-73] years) who had all three samples were included. Combined analysis of ttDNA and baseline-cfDNA revealed that TP53 (58.7%) was the most frequently mutated gene, followed by CDH1 (26.1%), KRAS (21.7%), and APC (13.0%). For these genes, the sensitivity and positive predictive value of baseline-cfDNA over ttDNA were 71.8% and 51.9%, respectively. When baseline-cfDNA and PD-cfDNA results were combined, 34 patients (73.9%) were found to have additional mutations compared with ttDNA results alone. PD-cfDNA analysis revealed 14 novel pathogenic mutations in ten patients (21.7%). At baseline, patients with a high circulating tumor DNA fraction concentration showed a significantly shorter progression-free survival (PFS) (P = 0.016) in univariable and multivariable analyses. High maximal variant allele frequency (VAF) (P = 0.022), high sum of VAF (P = 0.028), and high TP53 VAF (P = 0.022) were associated with worse PFS in univariable analysis.</p><p><strong>Conclusions: </strong>Although cfDNA alone cannot replace ttDNA entirely, cfDNA analysis revealed additional mutations. Notably, PD-cfDNA analysis revealed novel pathogenic mutations that emerged during treatment. Moreover, the baseline circulating tumor DNA fraction concentration and VAF values were associated with longer PFS.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"620-630"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early angiographic changes after hemostatic radiotherapy for gastric cancer bleeding, mentioning the mechanism and potential immediate effects of the treatment.","authors":"Yuki Wada, Motoko Konno, Tomoki Tozawa, Tomochika Sato, Tetsugaku Shinozaki, Satoshi Kumagai, Noriko Takagi, Koji Fukuda, Hiroyuki Shibata, Naoko Mori","doi":"10.1007/s10120-025-01616-8","DOIUrl":"10.1007/s10120-025-01616-8","url":null,"abstract":"<p><p>Although hemostatic radiotherapy has been reported as an effective treatment for gastric cancer bleeding, its mechanism and immediate effects remain unclear. We experienced a case of gastric cancer bleeding originating from both the whole gastric tumor and a left gastric arterial pseudoaneurysm at the tumor-associated ulcer. The patient was treated with radiotherapy for bleeding from the whole gastric tumor, followed by transcatheter arterial embolization for the left gastric arterial pseudoaneurysm. Angiography performed two hours after radiotherapy with an X-ray of 8 Gy in a single fraction revealed the disappearance of both tumor vessels and tumor stain from not only the embolized left gastric artery but also both the non-embolized right gastric artery and common trunk of the left gastric and the left hepatic arteries, which indicated these angiographic changes of the non-embolized arteries were presumed to reflect an immediate effect of hemostatic radiotherapy. Following hemostatic treatments, the patient's vital signs stabilized, and hemoglobin levels did not decrease, indicating immediate hemostasis. This case suggests a link between hemostatic mechanism and early tumor vessel changes, indicating that hemostatic radiotherapy can achieve rapid bleeding control. Therefore, hemostatic radiotherapy should be considered an emergency treatment option for gastric cancer bleeding.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"712-717"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase Ib study of photoimmunotherapy with ASP-1929 in combination with nivolumab for advanced gastric cancer (GE-PIT, EPOC1901).","authors":"Tomohiro Kadota, Rika Fujii, Shohei Koyama, Daisuke Kotani, Yusuke Yoda, Miki Fukutani, Mitsuko Suzuki, Masashi Wakabayashi, Takashi Ikeno, Hironori Sunakawa, Yoshiaki Nakamura, Akihito Kawazoe, Takuma Irie, Nozomu Fuse, Akihiro Sato, Tomonori Yano, Kohei Shitara","doi":"10.1007/s10120-025-01623-9","DOIUrl":"10.1007/s10120-025-01623-9","url":null,"abstract":"<p><strong>Background: </strong>Photoimmunotherapy with ASP-1929 (cetuximab conjugated to IRDye 700DX) and 690-nm red light has shown promising results, with a 43% objective response rate (ORR) in a phase IIa trial for recurrent head and neck squamous cell carcinoma. This study aimed to evaluate the safety and efficacy of combining photoimmunotherapy with nivolumab for advanced gastric cancer.</p><p><strong>Methods: </strong>This phase Ib open-label, single-center trial investigated the combination of photoimmunotherapy with ASP-1929 and nivolumab in patients with unresectable EGFR-positive gastric adenocarcinoma after standard chemotherapy. The dose-escalation part aimed to determine the recommended dose of laser illumination energy under endoscopy, and the expansion part assessed the safety and efficacy at the determined dose. The primary endpoint was dose-limiting toxicity (DLT), and treatment response and adverse events were evaluated.</p><p><strong>Results: </strong>Between October 2019 and April 2022, 21 patients were enrolled. All patients had previously received at least two lines of chemotherapy, with six being refractory to anti-PD-1 therapy. No DLT was observed, and the recommended dose was 100 J/cm². Two patients achieved a partial response, and ORR was 9.5%.</p><p><strong>Conclusion: </strong>This study demonstrated that combining endoscopic photoimmunotherapy with nivolumab is safe and feasible for advanced gastric cancer.</p><p><strong>Trial registry: </strong>The trial is registered in the Japanese Registry of Clinical Trials (identifier: jRCT2080224884, https://jrct.niph.go.jp/en-latest-detail/jRCT2080224884 ).</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"718-724"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Function-preserving gastrectomy based on the sentinel node concept prevents osteosarcopenia in patients with gastric cancer.","authors":"Yuki Hirase, Takaaki Arigami, Daisuke Matsushita, Masataka Shimonosono, Yoshikazu Uenosono, Shigehiro Yanagita, Yusuke Tsuruda, Ken Sasaki, Kenji Baba, Yota Kawasaki, Takao Ohtsuka","doi":"10.1007/s10120-025-01617-7","DOIUrl":"10.1007/s10120-025-01617-7","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer remains a significant global challenge, with conventional surgery for early gastric cancer often leading to post-gastrectomy complications. Sentinel node navigation surgery is being developed to preserve quality of life without compromising radicality. Although osteosarcopenia is linked to gastrointestinal cancers and prognosis, its impact on bone and muscle mass after function-preserving surgery for gastric cancer remains underexplored.</p><p><strong>Methods: </strong>We analyzed the data of patients diagnosed with early gastric cancer and not eligible for endoscopic treatments, who underwent either distal gastrectomy or sentinel node navigation surgery at our hospital between 2010 and 2020. Skeletal muscle index and bone mineral density were measured preoperatively and 1, 3, and 5 years, postoperatively; rates of changes in these measures were assessed.</p><p><strong>Results: </strong>Among the 63 patients included, 42 (67%) underwent conventional surgery, and 21 (33%) underwent function-preserving gastrectomy using the sentinel node technique. No significant difference in postoperative survival rates was observed between the two groups (P = 0.97). The rate of change in the skeletal muscle index and bone mineral density decreased in both groups from 1 to 3 years postoperatively. At 5 years postoperatively, the sentinel node navigation surgery group showed an increase in skeletal muscle index and bone mineral density change rates, the difference observed between the two groups was significant (P < 0.05).</p><p><strong>Conclusion: </strong>Sentinel node navigation surgery for early gastric cancer may help prevent decreases in bone and muscle mass. This suggests that its use has a potential role in preventing osteosarcopenia.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"696-704"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter phase II study on the efficacy of an oral nutritional supplement containing eicosapentaenoic acid in advanced gastric cancer patients with cachexia.","authors":"Ryohei Kawabata, Kazuhiro Nishikawa, Tomono Kawase, Junji Kawada, Yutaka Kimura, Yasushige Kashima, Shugo Ueda, Atsushi Takeno, Kazuhiro Shimomura, Hiroshi Imamura","doi":"10.1007/s10120-025-01605-x","DOIUrl":"10.1007/s10120-025-01605-x","url":null,"abstract":"<p><strong>Background: </strong>Cachexia is a common complication in advanced gastric cancer (AGC). Eicosapentaenoic acid (EPA) may ameliorate cachexia. This single-arm, phase II study assessed the potential benefit of an oral nutritional supplement containing EPA (ONS-EPA) for cachexia in AGC patients.</p><p><strong>Methods: </strong>Chemotherapy-naive AGC patients with cachexia, defined by serum albumin < 3.5 g/dl and C-reactive protein ≥ 0.5 mg/dl, were included. Patients received an EPA-enriched supplement (Prosure^®, 1.056 g EPA/pack) twice daily during first-line chemotherapy. The primary endpoint was time to treatment failure (TTF) in patients adhering to ≥ 25% of the planned ONS-EPA dose in the first two weeks (per-protocol set, PPS). Secondary analyses evaluated adherence impact on treatment outcomes.</p><p><strong>Results: </strong>Of 72 enrolled patients, 65 were evaluated. Median adherence was 42.8%. Median TTF in the PPS group was 4.8 months (95% CI 3.6-5.5), below the pre-set 4-month threshold. The PPS group had a higher proportion of patients who improved their nutritional and inflammatory status during treatment, along with better TTF and overall survival (OS) compared to those with poor adherence. Adjusted median TTF was 4.6 vs. 2.5 months (hazard ratio: 0.56; 95% CI 0.28-1.12, p = 0.105).</p><p><strong>Conclusions: </strong>Although the primary endpoint was not achieved, the study suggests that ONS-EPA may benefit AGC patients with cachexia.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"641-651"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}