강윤구 (울산대학교 의과대학)

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울산대학교 의과대학

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J. Clin. Oncol., Jul 12 2024, | https://doi.org/10.1200/JCO.23.02167 Neoadjuvant Docetaxel, Oxaliplatin, and S-1 Plus Surgery and Adjuvant S-1 for Resectable Advanced Gastric Cancer: Updated Overall Survival Outcomes From Phase III PRODIGY

Yoon-Koo Kang ¹, Hyung-Don Kim ¹, Jeong Hwan Yook², Young-Kyu Park³, Jong Seok Lee ⁴, Young-Woo Kim ⁵, Jin Young Kim⁶, Min-Hee Ryu¹, Sun Young Rha ⁷, Ik Joo Chung⁸, In-Ho Kim ⁹, Sang Cheul Oh ¹⁰, Young Soo Park ¹¹, Jae-Ho Cheong ¹², Oh Jeong ³, Mi Hwa Heo⁶, Hark Kyun Kim ⁵, ChoHyun Park¹³, Chang Hak Yoo ¹⁴, Seok Yun Kang ¹⁵, Dae Young Zang¹⁶, You Jin Jang ¹⁷, Ji Young Sul ¹⁸, Jong Gwang Kim ¹⁹, Beom Su Kim ², Seung-Hoon Beom⁷, Jun-Eul Hwang ⁸, Seung Wan Ryu ²⁰, Myeong-Cherl Kook ⁵, Baek-Yeol Ryoo ¹, Hyunki Kim ²¹, Moon-Won Yoo², Nam Su Lee ²², Sang Ho Lee ²³, Sung Hoon Noh²⁴

¹Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

²Department of Surgery, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.

³Department of Surgery, Chonnam National University Medical School, Hwasun, Republic of Korea.

⁴Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

⁵Center for Gastric Cancer, Research Institute & Hospital, National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Republic of Korea.

⁶Division of Hemato-Oncology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea.

⁷Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.

⁸Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeonnam, Republic of Korea.

⁹Division of Medical Oncology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

¹⁰Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.

¹¹Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

¹²Department of Surgery, Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea.

¹³Department of Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

¹⁴Department of Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.

¹⁵Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.

¹⁶Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.

¹⁷Department of Surgery, Korea University Guro Hospital, Seoul, Republic of Korea.

¹⁸Department of Surgery, Chungnam National University Hospital, Daejeon, Republic of Korea.

¹⁹Department of Internal Medicine, Kyungpook National University, Daegu, Republic of Korea.

²⁰Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.

²¹Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.

²²Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, Republic of Korea.

²³Department of Surgery, Kosin University Gospel Hospital, Busan, Republic of Korea.

²⁴Department of Surgery, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.

Corresponding author : Yoon-Koo Kang

Abstract

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.The phase III PRODIGY study demonstrated that neoadjuvant chemotherapy with docetaxel, oxaliplatin, and S-1 (DOS) followed by surgery and adjuvant S-1 chemotherapy (CSC) improved progression-free survival (PFS) compared with surgery followed by adjuvant S-1 (SC) for patients with resectable locally advanced gastric cancer (LAGC) with clinical T2-3N+ or T4Nany disease. The primary end point was PFS. Overall survival (OS) was the secondary end point. We herein report the long-term follow-up outcomes, including OS, from this trial. A total of 238 and 246 patients were randomly assigned to the CSC and SC arms, respectively, and were treated (full analysis set). As of the data cutoff (September 2022), the median follow-up duration of the surviving patients was 99.5 months. Compared with SC, CSC significantly increased the OS (adjusted hazard ratio [HR], 0.72; stratified log-rank P = .027) with an 8-year OS rate of 63.0% and 55.1% for the CSC and SC arms, respectively. CSC also significantly improved the PFS (HR, 0.70; stratified log-rank P = .016). In conclusion, neoadjuvant DOS chemotherapy, as part of perioperative chemotherapy, prolonged the OS of Asian patients with LAGC relative to patients treated with surgery and adjuvant S-1. It should be considered one of the standard treatment options for patients with LAGC in Asia.

논문정보

형식Research article
게재일2024년 07월 (BRIC 등록일 2024-07-16)
연구진국내 연구진
분야 생명과학 > 노화/암생물학

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