Two therapeutic regimens for advanced gastric carcinoma: DOS chemotherapy alone vs. trastuzumab combined with DOS

The purpose of this study was to explore the efficacy and safety of trastuzumab combined with docetaxel, oxaliplatin and S-1 (DOS regimen) in neoadjuvant chemotherapy for advanced gastric carcinoma.

A total of 106 patients with advanced gastric carcinoma were divided into Trastuzumab + DOS group (n=53) and DOS group (n=53). The HER-2-positive patients were treated with trastuzumab combined with DOS regimen, while the HER-2-negative patients were treated with DOS regimen alone. The imaging examination was performed to evaluate the efficacy every 2 cycles. Moreover, the short-term clinical efficacy, related adverse reactions and tumor pathological grade were observed and recorded in both groups, and the surgical resection rate, radical resection rate and postoperative complications were compared between the two groups.

In Trastuzumab + DOS group and DOS group, the objective response rate (ORR) was 66.0% and 52.8%, respectively, and the disease control rate (DCR) was 94.3% and 90.6%, respectively. Besides, the surgical resection rate was 94.3% and 90.6%, respectively, in the two groups, while the R0 resection rate in Trastuzumab + DOS group was significantly higher than that in DOS group. The pathological response rate (≥ grade 1b) was 80.0% and 60.4%, respectively, in the two groups, which was obviously higher in Trastuzumab + DOS group than that in DOS group. Besides, there was 1 case of pathological complete response (pCR) in Trastuzumab + DOS group, and 0 case of pCR in DOS group.

Compared with DOS chemotherapy alone, trastuzumab combined with DOS regimen can significantly improve the pathological response rate and R0 resection rate without increasing the risk of surgery in neoadjuvant chemotherapy for advanced gastric carcinoma, and the patient's tolerance is good, so it is worthy of clinical popularization and application.