Related Experiment Video
Updated: Jan 22, 2026
Establishment of Gastric Cancer Patient-derived Xenograft Models and Primary Cell Lines
Published on: July 19, 2019
Neoadjuvant docetaxel, oxaliplatin, and S-1 therapy for patients with large type 3 or type 4 gastric cancer: final
Shunji Endo1, Ryo Tanaka2, Toshifumi Yamaguchi3
1Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan.
Background:
Large type 3 (≥ 8 cm) and type 4 gastric cancers are associated with extremely poor prognoses. The phase III JCOG0501 trial, which evaluated neoadjuvant S-1 plus cisplatin, failed to demonstrate any survival benefits. Docetaxel, oxaliplatin, and S-1 (DOS) have been explored as more effective perioperative regimens for these tumors.
Methods:
Eligible patients had large type 3 or type 4 gastric cancer without distant metastases, except for positive peritoneal cytology (CY). Patients received three cycles of neoadjuvant DOS (docetaxel 40 mg/m2, oxaliplatin 100 mg/m2, and oral S-1 at 80 mg/m2/day for 14 days), followed by gastrectomy with ≥ D2 lymphadenectomy and one year of adjuvant docetaxel plus S-1. The primary endpoint was the 3 year progression-free survival (PFS) rate, with an expected value of 60% and a threshold of 45%. A one-sample log-rank test was performed with an α level of 0.10.
Results:
Of the 48 patients enrolled, 27 had type 4 tumors (56.2%), and 10 (20.8%) had CY1. Overall, 91.7% of patients completed neoadjuvant DOS. R0 resection rate was achieved in 89.6% of patients, a pathological response grade ≥ 1b in 66.7%, and negative CY conversion in 80.0%. The 3-year PFS rate was 37.5% (95% confidence interval [CI], 24.1-50.6%; 80% CI 28.6-46.4%; p = 0.960), and the 3-year overall survival rate was 52.1% (95% CI 37.2-65.0%).
Conclusions:
Although neoadjuvant DOS therapy demonstrated favorable pathological responses, the 3-year PFS did not exceed the predefined threshold, and a survival benefit was not demonstrated.
Insights
Neoadjuvant docetaxel, oxaliplatin, and S-1 (DOS) showed good pathological responses in large gastric cancers but did not meet the 3-year progression-free survival goal. Survival benefit was not demonstrated in this study.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Large type 3 and type 4 gastric cancers have poor prognoses.
- Previous trials like JCOG0501 using neoadjuvant S-1 plus cisplatin showed no survival benefit.
- Docetaxel, oxaliplatin, and S-1 (DOS) is an alternative perioperative regimen for these advanced tumors.
Purpose of the Study:
- To evaluate the efficacy of neoadjuvant docetaxel, oxaliplatin, and S-1 (DOS) in patients with large type 3 or type 4 gastric cancer.
- To assess the 3-year progression-free survival (PFS) rate as the primary endpoint.
- To determine if DOS regimen improves outcomes compared to historical data.
Main Methods:
- Patients with large type 3/4 gastric cancer and positive peritoneal cytology received neoadjuvant DOS therapy.
- The regimen included three cycles of DOS followed by gastrectomy with D2 lymphadenectomy.
- Adjuvant therapy consisted of one year of docetaxel plus S-1; the primary endpoint was 3-year PFS.
Main Results:
- Of 48 patients, 91.7% completed neoadjuvant DOS; 89.6% achieved R0 resection.
- Pathological response grade ≥1b was observed in 66.7%, and 80.0% had negative peritoneal cytology conversion.
- The 3-year PFS rate was 37.5%, falling short of the 60% expected value and 45% threshold.
Conclusions:
- Neoadjuvant DOS therapy achieved favorable pathological responses in large gastric cancers.
- However, the 3-year PFS rate did not surpass the predefined threshold.
- The study did not demonstrate a significant survival benefit for this perioperative regimen.
Related Concept Videos
01:26Gastric Phase of Digestion
When food enters the stomach, it stretches the stomach walls and activates stretch receptors. This triggers local reflexes of the enteric nervous system, mediated through the myenteric plexus. These...
01:17Gas Chromatography: Types of Columns and Stationary Phases
For an analyte to remain on the column for a sufficient amount of time, it must exhibit some level of compatibility (or...
01:23Types of RNA
Three main types of RNA are involved in protein synthesis: messenger RNA (mRNA), transfer RNA (tRNA), and ribosomal RNA (rRNA). These RNAs perform diverse functions and can be broadly classified as protein-coding or non-coding RNA. Non-coding RNAs play important roles in the regulation of gene expression in response to developmental and environmental changes. Non-coding RNAs in prokaryotes can be manipulated to develop more effective antibacterial drugs for human or animal use.
RNA...
02:13Types of Hormones
03:23Types of Radioactivity
Alpha (α) decay is the emission of an α particle from the nucleus. For example, polonium-210 undergoes α decay:
01:36Types of Toxins
Air pollutants, primarily gases, pose significant threats to respiratory health, leading to conditions like hypoxia, lung cancer, and in extreme cases, death.
Environmental pollutants like...