Gastric Flashcards
What population was studied in the MAGIC study for gastric cancer?
503 pts with Resectable stomach/GEJ adenoCA, lower esophagus
What regimen was studied in the MAGIC study for gastric cancer?
“<span>→Periop epirubicin, cisplatin and 5-FU (ECF) x3 pre and post-op then surgery</span> <br></br>vs. <br></br>→surgery alone”
What were the results of the MAGIC study for gastric cancer?
“<span>5-yr OS 36% chemo vs. 23% <br></br>LR 15% vs. 21%<br></br>No benefit in pathCR<br></br></span><br></br>”
What is the clinical relevance of INT0116 for gastric cancer?
This trial showed improved outcomes for gastric cancer with adjuvant chemoRT.
What population was studied in INT0116 for gastric cancer?
“603 pts with<span>completely</span> resected stomach (<span>D0 54%, D1 36%, D2 10%</span>) or GE junction adenoCA, <span>85% node positive</span>”
What regimen was studied in INT0116 for gastric cancer?
“→obs <br></br>vs. <br></br><span>→5FU/LV x1 → 45 Gy with concurrent 5FU/LV x2 → 5FU/LV x2</span>”
What were the results of INT0116 for gastric cancer?
“<div>Adjuvant chemoRT improves OS, RFS, LR, and DM in resected gastric cancer.<span><br></br></span></div><span><div><span><br></br></span></div>3-yr OS 50% vs. 42%<br></br>Median OS 36 mos chemoRT vs. 27 mos<br></br>RFS 48% vs. 31%</span><br></br>LR 19% vs. 29%<br></br>DM 33% vs. 18%<div><br></br></div><div><br></br></div>”
What is the clinical relevance of the CRITICs trial in gastric cancer?
Showed no difference in OS with peri-op chemo compared to adjuvant chemoRT in gastric cancer.
What population was studied in the CRITICs trial in gastric cancer?
788 pts with Stage IB-IVA gastric or gastric esophageal adenocarcinoma AJCC 6th
What regimen was studied in the CRITICs trial in gastric cancer?
ECC or EOC (epirubicin/(cis or ox)/cape) → D1 surg → ECC <br></br>vs. <br></br>→ECC → D1 surg → 45 Gy RT cape/cis<div><br></br></div>
What were the results of the CRITICs trial in gastric cancer?
<div>No OS difference but worse heme toxicity with chemo arm.</div>
<div><br></br></div>
5-yr OS ~41% both arms<br></br>Median OS 43 mos vs. 37 mos (p=0.9)<br></br><br></br>Post-op nonfebrile neutropenia 34% vs. 4%
What was the clinical relevance of the ARTIST trial for gastric cancer?
Showed that chemo alone can be used adjuvantly for gastric cancer (except for node+ and intestinal subtype).
What population was studied in the ARTIST trial for gastric cancer?
458 pts with Stage IB-IVA gastric, East Asia
What regimen was studied in the ARTIST trial for gastric cancer?
D2 surgery, R0 →<br></br><br></br>→cape/cis <br></br>vs. <br></br>→cape/cis → RT+cape -→ cape/cis
What were the results of the ARTIST trial for gastric cancer?
“Trend to improved DFS ~75% (p=0.09) <br></br>5-yr OS ~75% (NS)<br></br><span>DFS benefit in node positive and intestinal subtype</span>”
What is the clinical relevance of the ARTIST2 trial for gastric cancer?
Showed no benefit to adding RT to SOX (chemo) adjuvantly for gastric cancer.
What population was studied in the ARTIST2 trial for gastric cancer?
538 pts with Stage II-III gastric, D2 resected, N+
What regimen was studied in the ARTIST2 trial for gastric cancer?
→S1 vs.<br></br>→S1+oxaliplatin vs.<br></br>→S1+oxaliplatin+45 Gy RT
What were the results of the ARTIST2 trial for gastric cancer?
Trial stopped early due to futility<br></br>No difference in OS for SOX vs. SOXRT (p=0.057)<br></br>3-yr DFS 78% vs. 73%
What was the clinical relevance of RTOG 9904 for gastric cancer?
Explored neoadjuvant chemoRT for gastric cancer. Showed favorable results. Currently being evaluated in TOPGEAR study.
What population was studied in RTOG 9904 for gastric cancer?
49 pts with localized gastric adenocarcinoma
What regimen was studied in RTOG 9904 for gastric cancer?
Phase II: pre-op cis/5FU x2 → concurrent chemoRT 45 Gy with 5FU and weekly taxol → resection
What were the results of RTOG 9904 for gastric cancer?
<div>Favorable results:</div>
<div><br></br></div>
pCR 26%, 1 yr OS 72%, Median OS 23 mos<br></br><br></br>If pCR, then 1 yr OS 82%
What was the clinical relevance of CALGB 80101 for gastric cancer?
Showed that ECF with RT has less toxicity than 5FU with RT for adjuvant gastric cancer treatment.
vs.
→ECF → RT/5FU → ECF
With ECF, less diarrhea, mucositis, dehydration, and neutropenia
(44% gastric, 56% GEJ, 80% N+)"
vs.
→ECF or ECX"
Median OS 50 mos vs. 35 mos
5-yr OS 45% vs. 36%
DFS 30 mos vs. 18 mos
Toxicity similar. Like ECF, FLOT4 is poorly tolerated with 46% completion
vs.
→D2 surgery with 45 Gy RT + 5FU
→S1 for one year vs.
→obs"
→cape/ox
vs.
→obs"
5-yr OS 78% vs. 69%
