New stomach cancer treatment recommended by NICE after 'light-touch' assessment

Cancer research · Gastric cancer

Neoadjuvant docetaxel, oxaliplatin, and S‑1 followed by surgery and adjuvant S‑1 improves progression‑free survival compared with surgery followed by adjuvant S‑1 alone in patients with resectable locally advanced gastric cancer.

The PRODIGY phase‑III trial evaluated whether neoadjuvant docetaxel, oxaliplatin, and S‑1 (DOS) followed by surgery and adjuvant S‑1 improves outcomes versus standard surgery and adjuvant S‑1 in Korean patients with resectable locally advanced gastric cancer (LAGC). 266 patients received the CSC (neoadjuvant DOS + surgery + adjuvant S‑1) arm and 264 received the SC (surgery + adjuvant S‑1) arm. The primary endpoint, progression‑free survival (PFS), was significantly better in the CSC arm (adjusted hazard ratio 0.70, 95% CI 0.52‑0.95, P = .023). Treatment was well tolerated with comparable safety profiles. The study demonstrates that perioperative DOS chemotherapy is effective and tolerable for LAGC.

Adding neoadjuvant DOS chemotherapy enhances PFS in resectable locally advanced gastric cancer, offering a potential new standard of care in Asia comparable to perioperative strategies used in Western countries. This approach could translate into improved long‑term outcomes for a disease with historically limited survival benefits from adjuvant therapy alone.

Evidence level: Irányelv / elfogadott gyakorlat. Magas szintű klinikai elfogadottság.

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