RESUMEN
The current study aimed to evaluate the efficacy and safety of neoadjuvant apatinib plus tegafur/gimeracil/oteracil potassium (S-1) plus oxaliplatin (SOX) chemotherapy in patients with locally advanced gastric carcinoma (LAGC). Therefore, patients with LAGC treated with neoadjuvant apatinib plus SOX chemotherapy (apatinib + SOX group; n=25) or SOX chemotherapy (SOX group; n=35) were enrolled in the present study. Subsequently, the objective response (ORR) and disease control rates (DCR), pathological response, disease-free survival (DFS), overall survival (OS) and adverse events were recorded. The results showed that patients in the apatinib + SOX group exhibited a higher ORR (64.0 vs. 37.1%; P=0.040), but a similar DCR (96.0 vs. 88.6%; P=0.580), compared with those in the SOX group. The pathological response rates in patients with grade 0, 1, 2 and 3 LAGC were 0.0, 20.8, 62.5 and 16.7%, respectively, in the apatinib + SOX group, while in those treated with SOX alone they were 9.1, 39.4, 42.4 and 9.1%, respectively. By contrast, the pathological response was elevated in the apatinib + SOX group compared with the SOX group (P=0.030). During a median follow-up period of 21.0 months (range, 6.4-38.1 months), median DFS and OS were not reached. More specifically, the 1-, 2- and 3-year DFS rates were 91.7, 75.2 and 75.2% in the apatinib + SOX group and 71.8, 59.6 and 44.7% in the SOX group, respectively. In addition, the 1-, 2- and 3-year OS rates were 100.0, 89.6 and 78.4% in the apatinib + SOX group, while those in the SOX group were 90.3, 69.2 and 55.4%, respectively. However, no differences in DFS (P=0.094) or OS (P=0.155) were observed between the two groups. Additionally, the most common adverse events in the SOX group were mild leukopenia (42.9%) and fatigue (34.3%), while those in the apatinib + SOX group were tolerable leukopenia (44.0%) and hypertension (44.0%). In conclusion, the present study suggested that neoadjuvant apatinib plus SOX chemotherapy could be more effective and tolerable compared with SOX chemotherapy alone in patients with LAGC.
RESUMEN
Background: Bevacizumab (BEV) plus chemotherapy as a neoadjuvant regimen presents good efficacy in patients with locally advanced cancer. However, its role in patients with locally advanced gastric cancer (LAGC) is not clear. Thus, the study aimed to assess the efficacy and safety of neoadjuvant BEV plus chemotherapy in patients with LAGC. Methods: Twenty resectable patients with LAGC who received BEV plus docetaxel/cisplatin/capecitabine (DCC) chemotherapy for 3 cycles with 21 days as one cycle as neoadjuvant regimen were involved. Besides, their treatment response, survival profiles, and adverse events were assessed. Results: In total, two (10.0%), 9 (45.0%), 8 (40.0%), and 1 (5.0%) patients achieved complete remission, partial remission, stable disease, and progressive disease (PD) according to imaging evaluation, which resulted in 55.0% of objective response rate and 95.0% of disease control rate, respectively. Moreover, the number of patients with pathological response grades 1, 2, and 3 was 8 (40.0%), 8 (40.0%), and 3 (15.0%); while 1 (5.0%) patient did not receive surgery due to PD, thus the data of this patient was not assessable. Meanwhile, 18 (90.0%) patients achieved R0 resection. Regarding survival profile, the median disease-free survival or overall survival were both not reached. The 1-year, 2-, and 3-year disease-free survival rates were 88.8, 80.7, and 67.3%. Meanwhile, the 1-, 2-, and 3-year overall survival rates were 100.0%, 75.8%, and 75.8%, respectively. Additionally, the main adverse events were anemia (90.0%), alopecia (90.0%), leukopenia (70.0%), and anorexia (65.0%). Indeed, most adverse events were of grade 1 or 2 and were manageable. Conclusion: Neoadjuvant BEV plus DCC chemotherapy presents a favorable pathological response and survival profile with acceptable safety in patients with LAGC.
RESUMEN
BACKGROUND: Chaperonin-containing tailless complex polypeptide 1 subunit 6A (CCT6A) promotes several gastrointestinal-cancer malignant behaviors, while its clinical value in surgical gastric cancer is not clear. Hence, we aimed to investigate this issue. METHODS: Totally, tumor and adjacent specimens from 262 surgical gastric cancer patients were collected for measuring CCT6A protein level by immunohistochemistry (IHC) staining; meanwhile, specimens from 109 patients were used for evaluating CCT6A mRNA expression by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). RESULTS: CCT6A IHC score and CCT6A mRNA expression were upregulated in the tumor tissue compared with the adjacent tissue (both P<0.001). Besides, elevated CCT6A IHC score was correlated with larger tumor size (P<0.001), advanced T stage (P=0.001), N stage (P=0.003) and tumor node metastasis (TNM) stage (P=0.001). Meanwhile, increased CCT6A mRNA expression was associated with higher T stage (P=0.008) and TNM stage (P=0.020). Besides, CCT6A protein high (P=0.017) and CCT6A mRNA high (P=0.047) were correlated with unfavorable disease-free survival (DFS), whereas neither CCT6A protein nor CCT6A mRNA expression was related to the overall survival (OS) (both P>0.05). Additionally, the multivariable Cox's proportional hazards regression analysis revealed that CCT6A protein high was independently correlated with shorter DFS (adjusted hazard ratio (HR): 2.032, P=0.005), but not with OS. CONCLUSION: CCT6A is upregulated with its overexpression linking with advanced T stage, TNM stage and unfavorable DFS in surgical gastric cancer patients.