Short-term outcomes of preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis (JCOG1704)

Kurokawa, Yukinori; Doki, Yuichiro; Kitabayashi, Ryo; Yoshikawa, Takaki; Nomura, Takashi; Tsuji, Kunihiro; Goto, Masahiro; Cho, Haruhiko; Hihara, Jun; Hiki, Naoki; Nunobe, Souya; Mizusawa, Junki; Boku, Narikazu; Terashima, Masanori

doi:https://doi.org/10.1007/s10120-023-01453-7

Short-term outcomes of preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis (JCOG1704)

Kurokawa, Yukinori; Doki, Yuichiro; Kitabayashi, Ryo et al.

Gastric Cancer, 2024, 27(2), 366-374

Number of Access:1,104（2025-10-21 07:47 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/94636

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Title	Short-term outcomes of preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis (JCOG1704)
Creator	NRID 1000010470197 1000010470197 researchmap permalink krkw krkw Scopus Author ID 7202562410 7202562410 CreatorName Kurokawa, Yukinori
	NRID 1000020291445 1000020291445 researchmap permalink ydoki3251 ydoki3251 Scopus Author ID 7006390687 7006390687 CreatorName Doki, Yuichiro
	CreatorName Kitabayashi, Ryo
	NRID 1000030336573 1000030336573 CreatorName Yoshikawa, Takaki
	CreatorName Nomura, Takashi
	CreatorName Tsuji, Kunihiro
	CreatorName Goto, Masahiro
	CreatorName Cho, Haruhiko
	NRID 1000010322744 1000010322744 CreatorName Hihara, Jun
	NRID 1000030313026 1000030313026 CreatorName Hiki, Naoki
	CreatorName Nunobe, Souya
	CreatorName Mizusawa, Junki
	NRID 1000050505948 1000050505948 CreatorName Boku, Narikazu
	NRID 1000040197794 1000040197794 CreatorName Terashima, Masanori
Subject	Bulky nodal involvement
	Neoadjuvant chemotherapy
	Para-aortic nodal metastases
	Perioperative chemotherapy
	Preoperative DOS
Description	The version of record of this article, first published in Gastric Cancer, is available online at Publisher’s website: https://doi.org/10.1007/s10120-023-01453-7.
Abstract	Background: The prognosis for marginally resectable gastric cancer with extensive lymph node metastasis (ELM) remains unfavorable, even after R0 resection. To assess the safety and efficacy of preoperative docetaxel, oxaliplatin, and S-1 (DOS), we conducted a multicenter phase II trial. Methods: Eligibility criteria included histologically proven HER2-negative gastric adenocarcinoma with bulky nodal (bulky N) involvement around major branched arteries or para-aortic node (PAN) metastases. Patients received three cycles of docetaxel (40 mg/m², day 1), oxaliplatin (100 mg/m², day 1), and S-1 (80–120 mg/body, days 1–14), followed by gastrectomy with D2 plus PAN dissection. Subsequently, patients underwent postoperative chemotherapy with S-1 for 1 year. The primary endpoint was major (grade ≥ 2a) pathological response rate (pRR) according to the Japanese Classification of Gastric Carcinoma criteria. Results: Between October 2018 and March 2022, 47 patients (bulky N, 20; PAN, 17; both, 10) were enrolled in the trial. One patient was ineligible. Another declined any protocol treatments before initiation. Among the 45 eligible patients who initiated DOS chemotherapy, 44 (98%) completed 3 cycles and 42 (93%) underwent R0 resection. Major pRR and pathological complete response rates among the 46 eligible patients, including the patient who declined treatment, were 57% (26/46) and 24% (11/46), respectively. Common grade 3 or 4 toxicities were neutropenia (24%), anorexia (16%), febrile neutropenia (9%), and diarrhea (9%). No treatment-related deaths occurred. Conclusions: Preoperative chemotherapy with DOS yielded favorable pathological responses with an acceptable toxicity profile. This multimodal approach is highly promising for treating gastric cancer with ELM.
Publisher	Springer
Source Title	Gastric Cancer
Volume (Issue)	27(2)
Page	366-374
Date of Issued	2024-03-01
Language	English
Handle URL	https://hdl.handle.net/11094/94636
PISSN	14363291
eISSN	14363305
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1007/s10120-023-01453-7
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Gastric Cancer. 2024, 27(2), p. 366-374
DC.title	Short-term outcomes of preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis (JCOG1704)
DC.creator	Kurokawa, Yukinori
	Doki, Yuichiro
	Kitabayashi, Ryo
	Yoshikawa, Takaki
	Nomura, Takashi
	Tsuji, Kunihiro
	Goto, Masahiro
	Cho, Haruhiko
	Hihara, Jun
	Hiki, Naoki
	Nunobe, Souya
	Mizusawa, Junki
	Boku, Narikazu
	Terashima, Masanori
DC.publisher	Springer
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2024-03-01
DC.identifier	https://doi.org/10.1007/s10120-023-01453-7
DC.subject	Bulky nodal involvement
	Neoadjuvant chemotherapy
	Para-aortic nodal metastases
	Perioperative chemotherapy
	Preoperative DOS
DC.description	The version of record of this article, first published in Gastric Cancer, is available online at Publisher’s website: https://doi.org/10.1007/s10120-023-01453-7.
DCTERMS.abstract	Background: The prognosis for marginally resectable gastric cancer with extensive lymph node metastasis (ELM) remains unfavorable, even after R0 resection. To assess the safety and efficacy of preoperative docetaxel, oxaliplatin, and S-1 (DOS), we conducted a multicenter phase II trial. Methods: Eligibility criteria included histologically proven HER2-negative gastric adenocarcinoma with bulky nodal (bulky N) involvement around major branched arteries or para-aortic node (PAN) metastases. Patients received three cycles of docetaxel (40 mg/m², day 1), oxaliplatin (100 mg/m², day 1), and S-1 (80–120 mg/body, days 1–14), followed by gastrectomy with D2 plus PAN dissection. Subsequently, patients underwent postoperative chemotherapy with S-1 for 1 year. The primary endpoint was major (grade ≥ 2a) pathological response rate (pRR) according to the Japanese Classification of Gastric Carcinoma criteria. Results: Between October 2018 and March 2022, 47 patients (bulky N, 20; PAN, 17; both, 10) were enrolled in the trial. One patient was ineligible. Another declined any protocol treatments before initiation. Among the 45 eligible patients who initiated DOS chemotherapy, 44 (98%) completed 3 cycles and 42 (93%) underwent R0 resection. Major pRR and pathological complete response rates among the 46 eligible patients, including the patient who declined treatment, were 57% (26/46) and 24% (11/46), respectively. Common grade 3 or 4 toxicities were neutropenia (24%), anorexia (16%), febrile neutropenia (9%), and diarrhea (9%). No treatment-related deaths occurred. Conclusions: Preoperative chemotherapy with DOS yielded favorable pathological responses with an acceptable toxicity profile. This multimodal approach is highly promising for treating gastric cancer with ELM.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	94636
citation_title	Short-term outcomes of preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis (JCOG1704)
citation_author	Kurokawa, Yukinori
	Doki, Yuichiro
	Kitabayashi, Ryo
	Yoshikawa, Takaki
	Nomura, Takashi
	Tsuji, Kunihiro
	Goto, Masahiro
	Cho, Haruhiko
	Hihara, Jun
	Hiki, Naoki
	Nunobe, Souya
	Mizusawa, Junki
	Boku, Narikazu
	Terashima, Masanori
citation_publisher	Springer
citation_language	English
citation_date	2024-03-01
citation_journal_title	Gastric Cancer
citation_volume	27
citation_issue	2
citation_firstpage	366
citation_lastpage	374
citation_doi	https://doi.org/10.1007/s10120-023-01453-7
citation_public_url	https://hdl.handle.net/11094/94636

Short-term outcomes of preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis (JCOG1704)

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