Clinical Edge Journal Scan

Key clinical point: In patients with early-stage gastric cancer and visceral obesity, robotic gastrectomy (RG) is associated with lower incidence of postoperative complications and improved survival vs. laparoscopic gastrectomy (LG).

Major finding: In patients with high visceral fat area (VFA), RG vs. LG was associated with lower incidences of all complications (2.7% vs. 8.2%; P = .019) and intra-abdominal infectious complications (2.0% vs. 6.6%; P = .048). LG was an independent risk factor for overall (odds ratio [OR] 3.281; P = .012) and intra-abdominal infectious (OR 3.462; P = .021) complications in patients with high VFA. The overall survival in patients with high VFA was significantly higher with RG vs. LG (P = .045).

Study details: This article reports a retrospective study of 1306 patients with clinical stage I-II gastric cancer who underwent minimally invasive gastrectomy between 2012 and 2020.

Disclosures: No funding source was identified for this study. The authors received personal fees outside this work.

Source: Hikage M et al. Advantages of a robotic approach compared with laparoscopy gastrectomy for patients with high visceral fat area. Surg Endosc. 2022 (Mar 16). Doi: 10.1007/s00464-022-09178-x

Key clinical point: In patients with early-stage gastric cancer and visceral obesity, robotic gastrectomy (RG) is associated with lower incidence of postoperative complications and improved survival vs. laparoscopic gastrectomy (LG).

Major finding: In patients with high visceral fat area (VFA), RG vs. LG was associated with lower incidences of all complications (2.7% vs. 8.2%; P = .019) and intra-abdominal infectious complications (2.0% vs. 6.6%; P = .048). LG was an independent risk factor for overall (odds ratio [OR] 3.281; P = .012) and intra-abdominal infectious (OR 3.462; P = .021) complications in patients with high VFA. The overall survival in patients with high VFA was significantly higher with RG vs. LG (P = .045).

Study details: This article reports a retrospective study of 1306 patients with clinical stage I-II gastric cancer who underwent minimally invasive gastrectomy between 2012 and 2020.

Disclosures: No funding source was identified for this study. The authors received personal fees outside this work.

Source: Hikage M et al. Advantages of a robotic approach compared with laparoscopy gastrectomy for patients with high visceral fat area. Surg Endosc. 2022 (Mar 16). Doi: 10.1007/s00464-022-09178-x

Key clinical point: In patients with early-stage gastric cancer and visceral obesity, robotic gastrectomy (RG) is associated with lower incidence of postoperative complications and improved survival vs. laparoscopic gastrectomy (LG).

Major finding: In patients with high visceral fat area (VFA), RG vs. LG was associated with lower incidences of all complications (2.7% vs. 8.2%; P = .019) and intra-abdominal infectious complications (2.0% vs. 6.6%; P = .048). LG was an independent risk factor for overall (odds ratio [OR] 3.281; P = .012) and intra-abdominal infectious (OR 3.462; P = .021) complications in patients with high VFA. The overall survival in patients with high VFA was significantly higher with RG vs. LG (P = .045).

Study details: This article reports a retrospective study of 1306 patients with clinical stage I-II gastric cancer who underwent minimally invasive gastrectomy between 2012 and 2020.

Disclosures: No funding source was identified for this study. The authors received personal fees outside this work.

Source: Hikage M et al. Advantages of a robotic approach compared with laparoscopy gastrectomy for patients with high visceral fat area. Surg Endosc. 2022 (Mar 16). Doi: 10.1007/s00464-022-09178-x

Key clinical point: Adjuvant chemotherapy (ACT) after neoadjuvant chemotherapy (NACT) and surgery significantly improved survival in patients with locally advanced gastric cancer (LAGC) with a lymph node ratio (LNR) of ≥9%.

Major finding: At 3 years, the overall survival (OS) was significantly higher in patients who received ACT (60.1% vs. 49.3%; P = .02) vs. those who did not. ACT was associated with significantly improved OS at 3 years in patients with higher (≥9%) LNR (46.6% vs. 21.7%; P < .001). ACT improved OS at 3 years in patients with an LNR of ≥9% in an external validation cohort (53.0% vs. 26.3%; P = .04).

Study details: This article reports on a multicenter retrospective cohort study including 353 patients with LAGC undergoing curative-intent gastrectomy after NACT and an external validation cohort of 109 patients.

Disclosures: No funding source was identified for this study. The authors declared no conflicts of interest.

Source: Lin J-X et al. Association of adjuvant chemotherapy with overall survival among patients with locally advanced gastric cancer after neoadjuvant chemotherapy. JAMA Netw Open. 2022;5(4):e225557 (Apr 1). Doi: 10.1001/jamanetworkopen.2022.5557

Key clinical point: Adjuvant chemotherapy (ACT) after neoadjuvant chemotherapy (NACT) and surgery significantly improved survival in patients with locally advanced gastric cancer (LAGC) with a lymph node ratio (LNR) of ≥9%.

Major finding: At 3 years, the overall survival (OS) was significantly higher in patients who received ACT (60.1% vs. 49.3%; P = .02) vs. those who did not. ACT was associated with significantly improved OS at 3 years in patients with higher (≥9%) LNR (46.6% vs. 21.7%; P < .001). ACT improved OS at 3 years in patients with an LNR of ≥9% in an external validation cohort (53.0% vs. 26.3%; P = .04).

Study details: This article reports on a multicenter retrospective cohort study including 353 patients with LAGC undergoing curative-intent gastrectomy after NACT and an external validation cohort of 109 patients.

Disclosures: No funding source was identified for this study. The authors declared no conflicts of interest.

Source: Lin J-X et al. Association of adjuvant chemotherapy with overall survival among patients with locally advanced gastric cancer after neoadjuvant chemotherapy. JAMA Netw Open. 2022;5(4):e225557 (Apr 1). Doi: 10.1001/jamanetworkopen.2022.5557

Key clinical point: Adjuvant chemotherapy (ACT) after neoadjuvant chemotherapy (NACT) and surgery significantly improved survival in patients with locally advanced gastric cancer (LAGC) with a lymph node ratio (LNR) of ≥9%.

Major finding: At 3 years, the overall survival (OS) was significantly higher in patients who received ACT (60.1% vs. 49.3%; P = .02) vs. those who did not. ACT was associated with significantly improved OS at 3 years in patients with higher (≥9%) LNR (46.6% vs. 21.7%; P < .001). ACT improved OS at 3 years in patients with an LNR of ≥9% in an external validation cohort (53.0% vs. 26.3%; P = .04).

Study details: This article reports on a multicenter retrospective cohort study including 353 patients with LAGC undergoing curative-intent gastrectomy after NACT and an external validation cohort of 109 patients.

Disclosures: No funding source was identified for this study. The authors declared no conflicts of interest.

Source: Lin J-X et al. Association of adjuvant chemotherapy with overall survival among patients with locally advanced gastric cancer after neoadjuvant chemotherapy. JAMA Netw Open. 2022;5(4):e225557 (Apr 1). Doi: 10.1001/jamanetworkopen.2022.5557

Key clinical point: Salty taste preference, always using table salt, and a greater high-salt and salt-preserved foods intake are associated with a higher risk for gastric cancer.

Major finding: The risk for gastric cancer was higher with salty vs. tasteless taste preference (adjusted odds ratio [aOR] 1.59; 95% CI 1.25-2.03), always vs. never using table salt (aOR 1.33; 95% CI 1.16-1.54), and the highest vs. lowest tertile of high-salt and salt-preserved foods intake (aOR 1.24; 95% CI 1.01-1.51). There was no significant association for the highest vs. lowest tertile of total sodium intake (aOR 1.08; 95% CI 0.82-1.43).

Study details: This study was an individual participant data meta-analysis of 25 studies including 10,283 patients with gastric cancer and 24,643 control individuals.

Disclosures: This study was supported by Portuguese Ministry of Science, Technology, and Higher Education; Instituto de Saúde Pública da Universidade do Porto; Associazione Italiana per la Ricerca sul Cancro; and others. The authors declared no conflicts of interest.

Source: Morais S et al. Salt intake and gastric cancer: A pooled analysis within the Stomach cancer Pooling (StoP) Project. Cancer Causes Control. 2022;33:779-791 (Mar 19). Doi: 10.1007/s10552-022-01565-y

Key clinical point: Salty taste preference, always using table salt, and a greater high-salt and salt-preserved foods intake are associated with a higher risk for gastric cancer.

Major finding: The risk for gastric cancer was higher with salty vs. tasteless taste preference (adjusted odds ratio [aOR] 1.59; 95% CI 1.25-2.03), always vs. never using table salt (aOR 1.33; 95% CI 1.16-1.54), and the highest vs. lowest tertile of high-salt and salt-preserved foods intake (aOR 1.24; 95% CI 1.01-1.51). There was no significant association for the highest vs. lowest tertile of total sodium intake (aOR 1.08; 95% CI 0.82-1.43).

Study details: This study was an individual participant data meta-analysis of 25 studies including 10,283 patients with gastric cancer and 24,643 control individuals.

Disclosures: This study was supported by Portuguese Ministry of Science, Technology, and Higher Education; Instituto de Saúde Pública da Universidade do Porto; Associazione Italiana per la Ricerca sul Cancro; and others. The authors declared no conflicts of interest.

Source: Morais S et al. Salt intake and gastric cancer: A pooled analysis within the Stomach cancer Pooling (StoP) Project. Cancer Causes Control. 2022;33:779-791 (Mar 19). Doi: 10.1007/s10552-022-01565-y

Key clinical point: Salty taste preference, always using table salt, and a greater high-salt and salt-preserved foods intake are associated with a higher risk for gastric cancer.

Major finding: The risk for gastric cancer was higher with salty vs. tasteless taste preference (adjusted odds ratio [aOR] 1.59; 95% CI 1.25-2.03), always vs. never using table salt (aOR 1.33; 95% CI 1.16-1.54), and the highest vs. lowest tertile of high-salt and salt-preserved foods intake (aOR 1.24; 95% CI 1.01-1.51). There was no significant association for the highest vs. lowest tertile of total sodium intake (aOR 1.08; 95% CI 0.82-1.43).

Study details: This study was an individual participant data meta-analysis of 25 studies including 10,283 patients with gastric cancer and 24,643 control individuals.

Disclosures: This study was supported by Portuguese Ministry of Science, Technology, and Higher Education; Instituto de Saúde Pública da Universidade do Porto; Associazione Italiana per la Ricerca sul Cancro; and others. The authors declared no conflicts of interest.

Source: Morais S et al. Salt intake and gastric cancer: A pooled analysis within the Stomach cancer Pooling (StoP) Project. Cancer Causes Control. 2022;33:779-791 (Mar 19). Doi: 10.1007/s10552-022-01565-y

Key clinical point: The use vs. nonuse of cimetropium bromide as premedication is associated with higher gastric neoplasm detection rate during esophagogastroduodenoscopy (EGD) screening.

Major finding: In 41,670 matched participants, the gastric neoplasm detection rate was significantly higher in the cimetropium bromide vs. control group (0.30% vs. 0.19%; P = .02). Cimetropium bromide use vs. nonuse was associated with a significantly higher combined detection rate of dysplasia and early gastric cancer (0.27% vs. 0.17%; P = .02). Cimetropium bromide was associated with higher odds for the detection of gastric neoplasms (odds ratio 1.42; P = .03).

Study details: This article reports a propensity score-matched retrospective cohort study of 67,683 participants who received EGD screening with cimetropium bromide (41.8%) or without (control group; 58.2%).

Disclosures: This study was supported by the Ministry of Education, Science, and Technology, Korea; and Myongji Hospital. The authors declared no competing interests.

Source: Kim SY et al. Assessment of cimetropium bromide use for the detection of gastric neoplasms during esophagogastroduodenoscopy. JAMA Netw Open. 2022;5(3):e223827 (Mar 23). Doi: 10.1001/jamanetworkopen.2022.3827

Key clinical point: The use vs. nonuse of cimetropium bromide as premedication is associated with higher gastric neoplasm detection rate during esophagogastroduodenoscopy (EGD) screening.

Major finding: In 41,670 matched participants, the gastric neoplasm detection rate was significantly higher in the cimetropium bromide vs. control group (0.30% vs. 0.19%; P = .02). Cimetropium bromide use vs. nonuse was associated with a significantly higher combined detection rate of dysplasia and early gastric cancer (0.27% vs. 0.17%; P = .02). Cimetropium bromide was associated with higher odds for the detection of gastric neoplasms (odds ratio 1.42; P = .03).

Study details: This article reports a propensity score-matched retrospective cohort study of 67,683 participants who received EGD screening with cimetropium bromide (41.8%) or without (control group; 58.2%).

Disclosures: This study was supported by the Ministry of Education, Science, and Technology, Korea; and Myongji Hospital. The authors declared no competing interests.

Source: Kim SY et al. Assessment of cimetropium bromide use for the detection of gastric neoplasms during esophagogastroduodenoscopy. JAMA Netw Open. 2022;5(3):e223827 (Mar 23). Doi: 10.1001/jamanetworkopen.2022.3827

Key clinical point: The use vs. nonuse of cimetropium bromide as premedication is associated with higher gastric neoplasm detection rate during esophagogastroduodenoscopy (EGD) screening.

Major finding: In 41,670 matched participants, the gastric neoplasm detection rate was significantly higher in the cimetropium bromide vs. control group (0.30% vs. 0.19%; P = .02). Cimetropium bromide use vs. nonuse was associated with a significantly higher combined detection rate of dysplasia and early gastric cancer (0.27% vs. 0.17%; P = .02). Cimetropium bromide was associated with higher odds for the detection of gastric neoplasms (odds ratio 1.42; P = .03).

Study details: This article reports a propensity score-matched retrospective cohort study of 67,683 participants who received EGD screening with cimetropium bromide (41.8%) or without (control group; 58.2%).

Disclosures: This study was supported by the Ministry of Education, Science, and Technology, Korea; and Myongji Hospital. The authors declared no competing interests.

Source: Kim SY et al. Assessment of cimetropium bromide use for the detection of gastric neoplasms during esophagogastroduodenoscopy. JAMA Netw Open. 2022;5(3):e223827 (Mar 23). Doi: 10.1001/jamanetworkopen.2022.3827

Key clinical point: Modified Glasgow prognostic score (mGPS) predicts sarcopenia and is a strong prognostic factor for overall survival in patients with advanced gastric cancer or esophagogastric junction cancer undergoing first-line treatment.

Major finding: Baseline mGPS was significantly correlated with baseline mean muscle attenuation (P < .0001). The mGPS was a strong prognostic factor for overall survival (P < .0001) and progression-free survival (P < .001).

Study details: Computed tomography was performed in 509 patients with advanced gastric or esophagogastric junction cancer from the phase 3 EXPAND trial who received first-line platinum-fluoropyrimidine chemotherapy.

Disclosures: No funding source was identified for this study. The authors received personal fees and research grants outside this work.

Source: Hacker UT et al. Modified Glasgow prognostic score (mGPS) is correlated with sarcopenia and dominates the prognostic role of baseline body composition parameters in advanced gastric and esophagogastric junction cancer patients undergoing first-line treatment from the phase III EXPAND trial. Ann Oncol. 2022 (Apr 4). Doi: 10.1016/j.annonc.2022.03.274

Key clinical point: Modified Glasgow prognostic score (mGPS) predicts sarcopenia and is a strong prognostic factor for overall survival in patients with advanced gastric cancer or esophagogastric junction cancer undergoing first-line treatment.

Major finding: Baseline mGPS was significantly correlated with baseline mean muscle attenuation (P < .0001). The mGPS was a strong prognostic factor for overall survival (P < .0001) and progression-free survival (P < .001).

Study details: Computed tomography was performed in 509 patients with advanced gastric or esophagogastric junction cancer from the phase 3 EXPAND trial who received first-line platinum-fluoropyrimidine chemotherapy.

Disclosures: No funding source was identified for this study. The authors received personal fees and research grants outside this work.

Source: Hacker UT et al. Modified Glasgow prognostic score (mGPS) is correlated with sarcopenia and dominates the prognostic role of baseline body composition parameters in advanced gastric and esophagogastric junction cancer patients undergoing first-line treatment from the phase III EXPAND trial. Ann Oncol. 2022 (Apr 4). Doi: 10.1016/j.annonc.2022.03.274

Key clinical point: Modified Glasgow prognostic score (mGPS) predicts sarcopenia and is a strong prognostic factor for overall survival in patients with advanced gastric cancer or esophagogastric junction cancer undergoing first-line treatment.

Major finding: Baseline mGPS was significantly correlated with baseline mean muscle attenuation (P < .0001). The mGPS was a strong prognostic factor for overall survival (P < .0001) and progression-free survival (P < .001).

Study details: Computed tomography was performed in 509 patients with advanced gastric or esophagogastric junction cancer from the phase 3 EXPAND trial who received first-line platinum-fluoropyrimidine chemotherapy.

Disclosures: No funding source was identified for this study. The authors received personal fees and research grants outside this work.

Source: Hacker UT et al. Modified Glasgow prognostic score (mGPS) is correlated with sarcopenia and dominates the prognostic role of baseline body composition parameters in advanced gastric and esophagogastric junction cancer patients undergoing first-line treatment from the phase III EXPAND trial. Ann Oncol. 2022 (Apr 4). Doi: 10.1016/j.annonc.2022.03.274

Key clinical point: Patients with undifferentiated-predominant mixed-type (MU) early-stage gastric cancer (EGC) had a higher risk for submucosal invasion and lymph node metastasis vs. pure undifferentiated-type (PU) EGC.

Major finding: Patients with MU vs. PU EGC had a significantly higher risk for submucosal invasion (odds ratio [OR] 2.19; 95% CI 1.90-2.52) and lymph node metastasis (OR 2.28; 95% CI 1.72-3.03). There was no difference in the risk for lymphovascular invasion in patients with MU vs. PU EGC (OR 1.81; 95% CI 0.84-3.87).

Study details: This article was a meta-analysis of 12 observational studies including 5644 patients with early gastric cancer.

Disclosures: This study was sponsored by the International Science and Technology Cooperation Fund of Changzhou, China, Young Medical Talents of Jiangsu Province, Changzhou Special Fund for Introducing Foreign Talents, and others. The authors declared no competing interests.

Source: Yang P et al. Undifferentiated-predominant mixed-type early gastric cancer is more aggressive than pure undifferentiated type: a systematic review and meta-analysis. BMJ Open. 2022;12:e054473 (Apr 7). Doi: 10.1136/bmjopen-2021-054473

Key clinical point: Patients with undifferentiated-predominant mixed-type (MU) early-stage gastric cancer (EGC) had a higher risk for submucosal invasion and lymph node metastasis vs. pure undifferentiated-type (PU) EGC.

Major finding: Patients with MU vs. PU EGC had a significantly higher risk for submucosal invasion (odds ratio [OR] 2.19; 95% CI 1.90-2.52) and lymph node metastasis (OR 2.28; 95% CI 1.72-3.03). There was no difference in the risk for lymphovascular invasion in patients with MU vs. PU EGC (OR 1.81; 95% CI 0.84-3.87).

Study details: This article was a meta-analysis of 12 observational studies including 5644 patients with early gastric cancer.

Disclosures: This study was sponsored by the International Science and Technology Cooperation Fund of Changzhou, China, Young Medical Talents of Jiangsu Province, Changzhou Special Fund for Introducing Foreign Talents, and others. The authors declared no competing interests.

Source: Yang P et al. Undifferentiated-predominant mixed-type early gastric cancer is more aggressive than pure undifferentiated type: a systematic review and meta-analysis. BMJ Open. 2022;12:e054473 (Apr 7). Doi: 10.1136/bmjopen-2021-054473

Key clinical point: Patients with undifferentiated-predominant mixed-type (MU) early-stage gastric cancer (EGC) had a higher risk for submucosal invasion and lymph node metastasis vs. pure undifferentiated-type (PU) EGC.

Major finding: Patients with MU vs. PU EGC had a significantly higher risk for submucosal invasion (odds ratio [OR] 2.19; 95% CI 1.90-2.52) and lymph node metastasis (OR 2.28; 95% CI 1.72-3.03). There was no difference in the risk for lymphovascular invasion in patients with MU vs. PU EGC (OR 1.81; 95% CI 0.84-3.87).

Study details: This article was a meta-analysis of 12 observational studies including 5644 patients with early gastric cancer.

Disclosures: This study was sponsored by the International Science and Technology Cooperation Fund of Changzhou, China, Young Medical Talents of Jiangsu Province, Changzhou Special Fund for Introducing Foreign Talents, and others. The authors declared no competing interests.

Source: Yang P et al. Undifferentiated-predominant mixed-type early gastric cancer is more aggressive than pure undifferentiated type: a systematic review and meta-analysis. BMJ Open. 2022;12:e054473 (Apr 7). Doi: 10.1136/bmjopen-2021-054473

Key clinical point: In patients with clinical stage T3/T4a N1-3 M0 gastric cancer, perioperative capecitabine plus oxaliplatin is feasible and associated with a good survival rate.

Major finding: The R0 resection rate was 78.4%. At 3 years, overall survival and relapse-free survival rates were 83.8% (95% CI 72.7%-96.5%) and 73.0% (95% CI 60.0%-88.8%), respectively.

Study details: A phase 2 OGSG 1601 study of 37 patients with clinical stage T3/T4a N1-3 M0 gastric cancer who received perioperative capecitabine plus oxaliplatin therapy.

Disclosures: This study was sponsored by the Osaka Gastrointestinal Cancer Chemotherapy Study Group. The authors declared consulting/advisory relationships, received research funding/honoraria, disclosed being employed or having ownership interests, held intellectual property/inventor/patent rights, or served on scientific advisory boards outside this work.

Source: Matsuyama J et al. Three-year outcomes of a phase II study of perioperative capecitabine plus Oxaliplatin Therapy for Clinical SS/SE N1-3 M0 Gastric Cancer (OGSG 1601). Oncologist. 2022;27(4):251-e304 (Apr 5). Doi: 10.1093/oncolo/oyab061

Key clinical point: In patients with clinical stage T3/T4a N1-3 M0 gastric cancer, perioperative capecitabine plus oxaliplatin is feasible and associated with a good survival rate.

Major finding: The R0 resection rate was 78.4%. At 3 years, overall survival and relapse-free survival rates were 83.8% (95% CI 72.7%-96.5%) and 73.0% (95% CI 60.0%-88.8%), respectively.

Study details: A phase 2 OGSG 1601 study of 37 patients with clinical stage T3/T4a N1-3 M0 gastric cancer who received perioperative capecitabine plus oxaliplatin therapy.

Disclosures: This study was sponsored by the Osaka Gastrointestinal Cancer Chemotherapy Study Group. The authors declared consulting/advisory relationships, received research funding/honoraria, disclosed being employed or having ownership interests, held intellectual property/inventor/patent rights, or served on scientific advisory boards outside this work.

Source: Matsuyama J et al. Three-year outcomes of a phase II study of perioperative capecitabine plus Oxaliplatin Therapy for Clinical SS/SE N1-3 M0 Gastric Cancer (OGSG 1601). Oncologist. 2022;27(4):251-e304 (Apr 5). Doi: 10.1093/oncolo/oyab061

Key clinical point: In patients with clinical stage T3/T4a N1-3 M0 gastric cancer, perioperative capecitabine plus oxaliplatin is feasible and associated with a good survival rate.

Major finding: The R0 resection rate was 78.4%. At 3 years, overall survival and relapse-free survival rates were 83.8% (95% CI 72.7%-96.5%) and 73.0% (95% CI 60.0%-88.8%), respectively.

Study details: A phase 2 OGSG 1601 study of 37 patients with clinical stage T3/T4a N1-3 M0 gastric cancer who received perioperative capecitabine plus oxaliplatin therapy.

Disclosures: This study was sponsored by the Osaka Gastrointestinal Cancer Chemotherapy Study Group. The authors declared consulting/advisory relationships, received research funding/honoraria, disclosed being employed or having ownership interests, held intellectual property/inventor/patent rights, or served on scientific advisory boards outside this work.

Source: Matsuyama J et al. Three-year outcomes of a phase II study of perioperative capecitabine plus Oxaliplatin Therapy for Clinical SS/SE N1-3 M0 Gastric Cancer (OGSG 1601). Oncologist. 2022;27(4):251-e304 (Apr 5). Doi: 10.1093/oncolo/oyab061

Key clinical point: Neoadjuvant treatment with apatinib in combination with oxaliplatin and capecitabine shows good response and a manageable safety profile in patients with locally advanced adenocarcinoma of the stomach or gastroesophageal junction.

Major finding: The objective response rate was 78.1%. Pathological complete response and pathological response was achieved in 6.3% and 34.4% of the patients, respectively. The most common grade 3-4 treatment-emergent adverse events were hypertension (28.1%) and thrombocytopenia (21.9%).

Study details: This article reports a single-center, single-arm, phase 2 study of 32 patients with locally advanced adenocarcinoma of the stomach or gastroesophageal junction undergoing gastrectomy with lymphadenectomy who received neoadjuvant oxaliplatin, capecitabine, and apatinib.

Disclosures: This study was funded by the National Natural Science Foundation of China. The authors declared no competing interests.

Source: Tang Z et al. Neoadjuvant apatinib combined with oxaliplatin and capecitabine in patients with locally advanced adenocarcinoma of stomach or gastroesophageal junction: a single-arm, open-label, phase 2 trial. BMC Med. 2022;20:107 (Apr 6). Doi: 10.1186/s12916-022-02309-0

Key clinical point: Neoadjuvant treatment with apatinib in combination with oxaliplatin and capecitabine shows good response and a manageable safety profile in patients with locally advanced adenocarcinoma of the stomach or gastroesophageal junction.

Major finding: The objective response rate was 78.1%. Pathological complete response and pathological response was achieved in 6.3% and 34.4% of the patients, respectively. The most common grade 3-4 treatment-emergent adverse events were hypertension (28.1%) and thrombocytopenia (21.9%).

Study details: This article reports a single-center, single-arm, phase 2 study of 32 patients with locally advanced adenocarcinoma of the stomach or gastroesophageal junction undergoing gastrectomy with lymphadenectomy who received neoadjuvant oxaliplatin, capecitabine, and apatinib.

Disclosures: This study was funded by the National Natural Science Foundation of China. The authors declared no competing interests.

Source: Tang Z et al. Neoadjuvant apatinib combined with oxaliplatin and capecitabine in patients with locally advanced adenocarcinoma of stomach or gastroesophageal junction: a single-arm, open-label, phase 2 trial. BMC Med. 2022;20:107 (Apr 6). Doi: 10.1186/s12916-022-02309-0

Key clinical point: Neoadjuvant treatment with apatinib in combination with oxaliplatin and capecitabine shows good response and a manageable safety profile in patients with locally advanced adenocarcinoma of the stomach or gastroesophageal junction.

Major finding: The objective response rate was 78.1%. Pathological complete response and pathological response was achieved in 6.3% and 34.4% of the patients, respectively. The most common grade 3-4 treatment-emergent adverse events were hypertension (28.1%) and thrombocytopenia (21.9%).

Study details: This article reports a single-center, single-arm, phase 2 study of 32 patients with locally advanced adenocarcinoma of the stomach or gastroesophageal junction undergoing gastrectomy with lymphadenectomy who received neoadjuvant oxaliplatin, capecitabine, and apatinib.

Disclosures: This study was funded by the National Natural Science Foundation of China. The authors declared no competing interests.

Source: Tang Z et al. Neoadjuvant apatinib combined with oxaliplatin and capecitabine in patients with locally advanced adenocarcinoma of stomach or gastroesophageal junction: a single-arm, open-label, phase 2 trial. BMC Med. 2022;20:107 (Apr 6). Doi: 10.1186/s12916-022-02309-0

Key clinical point: Replacing anthracycline with fractional docetaxel in the epirubicin, oxaliplatin, and capecitabine (EOX) regimen does not improve survival and increases toxicities in chemotherapy-naive patients with human epidermal growth factor receptor 2 (HER2)-negative gastric cancer.

Major finding: At data cutoff of interim analysis, no significant difference was reported between the two treatment groups in progression-free survival (hazard ratio [HR] 0.975; P = .885) and overall survival (HR 1.002; P = .992). Treatment modification (91% vs. 78%; P = .017) and grade ≥3 adverse event rates (51% vs. 43%) were higher in the docetaxel vs. EOX group.

Study details: This study was a randomized, parallel group, open-label phase 3 LEGA trial including 169 chemotherapy-naive patients with HER2-negative gastric cancer who were randomly assigned to receive either EOX or a docetaxel, oxaliplatin, and capecitabine regimen.

Disclosures: No funding source was identified for this work. The authors reported no competing interests.

Source: Rosati G et al. A randomized phase III study of fractionated docetaxel, oxaliplatin, capecitabine (low-tox) vs epirubicin, oxaliplatin and capecitabine (eox) in patients with locally advanced unresectable or metastatic gastric cancer: The LEGA trial. Gastric Cancer. 2022 (Mar 30). Doi: 10.1007/s10120-022-01292-y

Key clinical point: Replacing anthracycline with fractional docetaxel in the epirubicin, oxaliplatin, and capecitabine (EOX) regimen does not improve survival and increases toxicities in chemotherapy-naive patients with human epidermal growth factor receptor 2 (HER2)-negative gastric cancer.

Major finding: At data cutoff of interim analysis, no significant difference was reported between the two treatment groups in progression-free survival (hazard ratio [HR] 0.975; P = .885) and overall survival (HR 1.002; P = .992). Treatment modification (91% vs. 78%; P = .017) and grade ≥3 adverse event rates (51% vs. 43%) were higher in the docetaxel vs. EOX group.

Study details: This study was a randomized, parallel group, open-label phase 3 LEGA trial including 169 chemotherapy-naive patients with HER2-negative gastric cancer who were randomly assigned to receive either EOX or a docetaxel, oxaliplatin, and capecitabine regimen.

Disclosures: No funding source was identified for this work. The authors reported no competing interests.

Source: Rosati G et al. A randomized phase III study of fractionated docetaxel, oxaliplatin, capecitabine (low-tox) vs epirubicin, oxaliplatin and capecitabine (eox) in patients with locally advanced unresectable or metastatic gastric cancer: The LEGA trial. Gastric Cancer. 2022 (Mar 30). Doi: 10.1007/s10120-022-01292-y

Key clinical point: Replacing anthracycline with fractional docetaxel in the epirubicin, oxaliplatin, and capecitabine (EOX) regimen does not improve survival and increases toxicities in chemotherapy-naive patients with human epidermal growth factor receptor 2 (HER2)-negative gastric cancer.

Major finding: At data cutoff of interim analysis, no significant difference was reported between the two treatment groups in progression-free survival (hazard ratio [HR] 0.975; P = .885) and overall survival (HR 1.002; P = .992). Treatment modification (91% vs. 78%; P = .017) and grade ≥3 adverse event rates (51% vs. 43%) were higher in the docetaxel vs. EOX group.

Study details: This study was a randomized, parallel group, open-label phase 3 LEGA trial including 169 chemotherapy-naive patients with HER2-negative gastric cancer who were randomly assigned to receive either EOX or a docetaxel, oxaliplatin, and capecitabine regimen.

Disclosures: No funding source was identified for this work. The authors reported no competing interests.

Source: Rosati G et al. A randomized phase III study of fractionated docetaxel, oxaliplatin, capecitabine (low-tox) vs epirubicin, oxaliplatin and capecitabine (eox) in patients with locally advanced unresectable or metastatic gastric cancer: The LEGA trial. Gastric Cancer. 2022 (Mar 30). Doi: 10.1007/s10120-022-01292-y

Key clinical point: In patients with early-stage gastric cancer, laparoscopic sentinel node navigation surgery (LSNNS) fails to show noninferiority vs. laparoscopic standard gastrectomy (LSG).

Major finding: The median follow-up was 48.1 months. At 3 years, disease-free survival rates were 95.5% and 91.8% in the LSG and LSNNS groups, respectively (difference 3.7%; 95% CI −0.6% to 8.1%). The threshold difference for noninferiority was 5%. No differences were seen in disease-specific survival (P = .59) and overall survival (P = .17) rates at 3 years.

Study details: The prospective, multicenter, randomized controlled phase 3 SENORITA trial included 580 patients with stage IA gastric adenocarcinoma who were randomly assigned to undergo either LSG or LSNNS.

Disclosures: This work was supported by National Cancer Center, Republic of Korea. The authors received honoraria, research funding, or consulting or advisory fees. Dr. WJ Hyung reported being employed at, in a leadership role, owning stocks, and other ownership interests at Hutom.

Source: Kim Y-W et al. Laparoscopic sentinel node navigation surgery for stomach preservation in patients with early gastric cancer: A randomized clinical trial. J Clin Oncol. 2022 (Mar 24). Doi: 10.1200/JCO.21.02242

Key clinical point: In patients with early-stage gastric cancer, laparoscopic sentinel node navigation surgery (LSNNS) fails to show noninferiority vs. laparoscopic standard gastrectomy (LSG).

Major finding: The median follow-up was 48.1 months. At 3 years, disease-free survival rates were 95.5% and 91.8% in the LSG and LSNNS groups, respectively (difference 3.7%; 95% CI −0.6% to 8.1%). The threshold difference for noninferiority was 5%. No differences were seen in disease-specific survival (P = .59) and overall survival (P = .17) rates at 3 years.

Study details: The prospective, multicenter, randomized controlled phase 3 SENORITA trial included 580 patients with stage IA gastric adenocarcinoma who were randomly assigned to undergo either LSG or LSNNS.

Disclosures: This work was supported by National Cancer Center, Republic of Korea. The authors received honoraria, research funding, or consulting or advisory fees. Dr. WJ Hyung reported being employed at, in a leadership role, owning stocks, and other ownership interests at Hutom.

Source: Kim Y-W et al. Laparoscopic sentinel node navigation surgery for stomach preservation in patients with early gastric cancer: A randomized clinical trial. J Clin Oncol. 2022 (Mar 24). Doi: 10.1200/JCO.21.02242

Key clinical point: In patients with early-stage gastric cancer, laparoscopic sentinel node navigation surgery (LSNNS) fails to show noninferiority vs. laparoscopic standard gastrectomy (LSG).

Major finding: The median follow-up was 48.1 months. At 3 years, disease-free survival rates were 95.5% and 91.8% in the LSG and LSNNS groups, respectively (difference 3.7%; 95% CI −0.6% to 8.1%). The threshold difference for noninferiority was 5%. No differences were seen in disease-specific survival (P = .59) and overall survival (P = .17) rates at 3 years.

Study details: The prospective, multicenter, randomized controlled phase 3 SENORITA trial included 580 patients with stage IA gastric adenocarcinoma who were randomly assigned to undergo either LSG or LSNNS.

Disclosures: This work was supported by National Cancer Center, Republic of Korea. The authors received honoraria, research funding, or consulting or advisory fees. Dr. WJ Hyung reported being employed at, in a leadership role, owning stocks, and other ownership interests at Hutom.

Source: Kim Y-W et al. Laparoscopic sentinel node navigation surgery for stomach preservation in patients with early gastric cancer: A randomized clinical trial. J Clin Oncol. 2022 (Mar 24). Doi: 10.1200/JCO.21.02242