Preoperative docetaxel, cisplatin, and 5-fluorouracil for resectable esophagogastric junction adenocarcinoma: A retrospective study.

Authors

null

Toshiharu Hirose

Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan

Toshiharu Hirose , Shun Yamamoto , Kotoe Oshima , Hidekazu Hirano , Natsuko Okita Tsuda , Hirokazu Shoji , Satoru Iwasa , Yoshitaka Honma , Atsuo Takashima , Narikazu Boku , Zyunya Oguma , Koshiro Ishiyama , Hiroyuki Daiko , Ken Kato

Organizations

Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan, Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan, Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan, National Cancer Center Hospital, Tokyo, Japan, Department of Gastrointestinal Oncology, National Cancer Center Hospital, Tokyo, Japan, Department of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan

Research Funding

No funding received
None

Background: In Western countries, 5-FU plus leucovorin, oxaliplatin, docetaxel (DTX) (FLOT) is the standard perioperative treatment for resectable gastric adenocarcinoma and esophagogastric junction adenocarcinoma (EGJ-AC). Preoperative chemotherapy with DTX plus cisplatin and 5-FU (DCF) has been developed for esophageal squamous cell carcinoma in Japan. However, there have been few reports on the safety and efficacy of preoperative triple therapy for resectable EGJ-AC. Methods: The subjects of this retrospective study were patients (pts) with histologically confirmed resectable EGJ-AC who received preoperative DCF chemotherapy (DTX 70 mg/㎡ and cisplatin 70 mg/㎡ on day 1, and continuous infusion of 5-FU 750 mg/㎡/day on days 1–5, every 3 weeks with a maximum of three cycles) at our hospital from Jan 2015 to Apr 2020. We evaluated the completion rate of >2 courses of DCF and R0 resection in all cases, and also examined histological response, progression-free survival (PFS), overall survival (OS), and adverse events during preoperative chemotherapy. Results: Thirty-two pts were included in this study, and the median observation period was 13.1 months (3.9–57.2). Characteristics were median age (range) 63 (42–80) years, PS 0/1 66/34%, clinical stage I/IIA/IIB/III/IVA/IVB (supraclavicular lymph node) 3/13/3/10/22/32/13%. Treatment completion rate was 84%. Histological response (grade 1a/1b/2/3) was obtained in 18/8/4/1 (58/26/13/3%) pts. Median PFS (95%CI) was 16.8 months (15.0–18.5), and median OS was not reached (3-year OS rate 73.8%). Grade >3 adverse events were observed in 20(63%) pts (neutropenia in 14 [44%], febrile neutropenia in 4 [13%]). No treatment-related deaths occurred. Conclusions: Preoperative DCF chemotherapy for resectable EGJ-AC was well tolerated. Further investigation is required to evaluate the long-term efficacy of this treatment strategy.

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Abstract Details

Meeting

2021 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session: Esophageal and Gastric Cancer

Track

Esophageal and Gastric Cancer

Sub Track

Therapeutics

Citation

J Clin Oncol 39, 2021 (suppl 3; abstr 209)

DOI

10.1200/JCO.2021.39.3_suppl.209

Abstract #

209

Poster Bd #

Online Only

Abstract Disclosures