Adjuvant treatment for locally advanced gastric cancer: an Asian perspective.

IF 6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gastric Cancer Pub Date : 2024-05-01 Epub Date: 2024-03-15 DOI:10.1007/s10120-024-01484-8
Hyung-Don Kim, Min-Hee Ryu, Yoon-Koo Kang
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Abstract

Standard adjuvant treatment for locally advanced gastric cancer (LAGC) is regionally different. Whereas perioperative chemotherapy is the standard in Western populations, D2 gastrectomy followed by adjuvant chemotherapy has been the standard in East Asia. Recently, the pivotal phase 3 PRODIGY and RESOLVE studies have demonstrated survival benefits of adding neoadjuvant chemotherapy to surgery followed by adjuvant chemotherapy over up-front surgery followed by adjuvant chemotherapy in Asian patients. Based on these results, neoadjuvant chemotherapy is considered one of the viable options for patients with LAGC. In this review, various aspects of neoadjuvant chemotherapy will be discussed for its optimal application in Asia. Candidates for neoadjuvant chemotherapy should be carefully chosen in consideration of the inaccurate aspects of radiological clinical staging and its potential benefit over up-front surgery followed by a decision on adjuvant chemotherapy according to the pathological stage. Efforts should continuously be made to optimally apply neoadjuvant chemotherapy to patients with LAGC, considering various factors, including a more accurate radiological assessment of the tumor burden and the optimization of post-operative chemotherapy. Future neoadjuvant trials involving novel agents for Asian patients should be designed based on proven Asian regimens rather than adopting Western regimens.

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局部晚期胃癌的辅助治疗:亚洲视角。
局部晚期胃癌(LAGC)的标准辅助治疗因地区而异。在西方国家,围手术期化疗是标准治疗,而在东亚地区,D2胃切除术后辅助化疗一直是标准治疗。最近,PRODIGY 和 RESOLVE 两项关键性三期研究表明,在亚洲患者中,在手术后辅助化疗的基础上增加新辅助化疗比先行手术后辅助化疗更有利于患者生存。基于这些结果,新辅助化疗被认为是LAGC患者的可行方案之一。在这篇综述中,我们将讨论新辅助化疗的各个方面,以便在亚洲实现最佳应用。新辅助化疗的候选者应谨慎选择,考虑到放射学临床分期的不准确性及其与先期手术相比的潜在益处,然后根据病理分期决定是否进行辅助化疗。考虑到各种因素,包括对肿瘤负荷进行更准确的放射学评估和优化术后化疗,应继续努力优化 LAGC 患者的新辅助化疗。未来针对亚洲患者的新辅助化疗试验应基于成熟的亚洲方案,而不是采用西方方案。
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来源期刊
Gastric Cancer
Gastric Cancer 医学-胃肠肝病学
CiteScore
14.70
自引率
2.70%
发文量
80
审稿时长
6-12 weeks
期刊介绍: Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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