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Gastric Cancer In The Precision Medicine Era pp 133–145Cite as

Combined Modality Treatment for Locally Advanced Gastric Cancer: Current Evidences and New Perspectives

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Abstract

Since benefits have been demonstrated in trials with perioperative chemotherapy, postoperative chemoradiotherapy, and preoperative chemoradiotherapy for patients with locally advanced gastric cancer, a second generation of randomized clinical trials evaluated some refinements of these treatment strategies. These trials included innovative combined modality programs with new drug-radiation combinations and advanced radiation therapy techniques followed by standardized gastric radical surgery to answer the several questions that emerged from the original landmark trials. The results of these trials have been recently reported and will be analyzed. Questions about patient selection and the optimal sequence and timing of treatments in the integrated approach still remain. As tumor location and histologic subtypes are associated to different aggressiveness, treatment response, and prognosis, future studies need to give more focus on gastroesophageal junction and stomach cancer as separate diseases to provide more solid data in these established tumor types. Furthermore, the new insights into histological patterns and molecular characterization of individual tumor subtype could address new and more individualized generation of combined modality treatment programs.

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References

  1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):10–29.

    Article  Google Scholar 

  2. Crew KD, Neugut AI. Epidemiology of gastric cancer. World J Gastroenterol. 2006;12(3):354–62.

    Article  Google Scholar 

  3. Reim D, Loos M, Vogl F, Novotny A, Schuster T, Langer R, et al. Prognostic implications of the seventh edition of the international union against cancer classification for patients with gastric cancer: the Western experience of patients treated in a single-center European institution. J Clin Oncol Off J Am Soc Clin Oncol. 2013;31(2):263–71.

    Article  Google Scholar 

  4. Lise M, Nitti D, Marchet A, Sahmoud T, Duez N, Fornasiero A, et al. Prognostic factors in resectable gastric cancer: results of EORTC study no. 40813 on FAM adjuvant chemotherapy. Ann Surg Oncol. 1995;2(6):495–501.

    Article  CAS  Google Scholar 

  5. Yoo CH, Noh SH, Shin DW, Choi SH, Min JS. Recurrence following curative resection for gastric carcinoma. Br J Surg. 2000;87(2):236–42.

    Article  CAS  Google Scholar 

  6. Wu C-W, Lo S-S, Shen K-H, Hsieh M-C, Chen J-H, Chiang J-H, et al. Incidence and factors associated with recurrence patterns after intended curative surgery for gastric cancer. World J Surg. 2003;27(2):153–8.

    PubMed  Google Scholar 

  7. D’Angelica M, Gonen M, Brennan MF, Turnbull AD, Bains M, Karpeh MS. Patterns of initial recurrence in completely resected gastric adenocarcinoma. Ann Surg. 2004;240(5):808–16.

    Article  Google Scholar 

  8. Songun I, Putter H, Kranenbarg EM-K, Sasako M, van de Velde CJH. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol. 2010;11(5):439–49.

    Article  Google Scholar 

  9. Sasako M, Sano T, Yamamoto S, Kurokawa Y, Nashimoto A, Kurita A, et al. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. N Engl J Med. 2008;359(5):453–62.

    Article  CAS  Google Scholar 

  10. Verlato G, Roviello F, Marchet A, Giacopuzzi S, Marrelli D, Nitti D, et al. Indexes of surgical quality in gastric cancer surgery: experience of an Italian network. Ann Surg Oncol. 2009;16(3):594–602.

    Article  CAS  Google Scholar 

  11. Sano T, Sasako M, Mizusawa J, Yamamoto S, Katai H, Yoshikawa T, et al. Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma. Ann Surg. 2017;265(2):277–83.

    Article  Google Scholar 

  12. Mocellin S, McCulloch P, Kazi H, Gama-Rodrigues JJ, Yuan Y, Nitti D. Extent of lymph node dissection for adenocarcinoma of the stomach. Cochrane Database Syst Rev. 2015;8:CD001964.

    Google Scholar 

  13. GASTRIC (Global Advanced/Adjuvant Stomach Tumor Research International Collaboration) Group, Paoletti X, Oba K, Burzykowski T, Michiels S, Ohashi Y, et al. Benefit of adjuvant chemotherapy for resectable gastric cancer: a meta-analysis. JAMA. 2010;303(17):1729–37.

    Article  Google Scholar 

  14. Sun P, Xiang J-B, Chen Z-Y. Meta-analysis of adjuvant chemotherapy after radical surgery for advanced gastric cancer. Br J Surg. 2009;96(1):26–33.

    Article  CAS  Google Scholar 

  15. Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345(10):725–30.

    Article  CAS  Google Scholar 

  16. Smalley SR, Benedetti JK, Haller DG, Hundahl SA, Estes NC, Ajani JA, et al. Updated analysis of SWOG-directed intergroup study 0116: a phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J Clin Oncol Off J Am Soc Clin Oncol. 2012;30(19):2327–33.

    Article  CAS  Google Scholar 

  17. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJH, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11–20.

    Article  CAS  Google Scholar 

  18. Boige V, Pignon J, Saint-Aubert B, Lasser P, Conroy T, Bouché O, et al. Final results of a randomized trial comparing preoperative 5-fluorouracil (F)/cisplatin (P) to surgery alone in adenocarcinoma of stomach and lower esophagus (ASLE): FNCLCC ACCORD07-FFCD 9703 trial. J Clin Oncol. 2007;25(18_suppl):4510.

    Google Scholar 

  19. Fazio N, Biffi R, Maibach R, Hayoz S, Thierstein S, Brauchli P, et al. Preoperative versus postoperative docetaxel-cisplatin-fluorouracil (TCF) chemotherapy in locally advanced resectable gastric carcinoma: 10-year follow-up of the SAKK 43/99 phase III trial. Ann Oncol. 2016;27(4):668–73.

    Article  CAS  Google Scholar 

  20. Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357(18):1810–20.

    Article  CAS  Google Scholar 

  21. Bang Y-J, Kim Y-W, Yang H-K, Chung HC, Park Y-K, Lee KH, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet Lond Engl. 2012;379(9813):315–21.

    Article  CAS  Google Scholar 

  22. De Vita F, Giuliani F, Orditura M, Maiello E, Galizia G, Di Martino N, et al. Adjuvant chemotherapy with epirubicin, leucovorin, 5-fluorouracil and etoposide regimen in resected gastric cancer patients: a randomized phase III trial by the Gruppo Oncologico Italia Meridionale (GOIM 9602 study). Ann Oncol. 2007;18(8):1354–8.

    Article  Google Scholar 

  23. Cascinu S, Labianca R, Barone C, Santoro A, Carnaghi C, Cassano A, et al. Adjuvant treatment of high-risk, radically resected gastric cancer patients with 5-fluorouracil, leucovorin, cisplatin, and epidoxorubicin in a randomized controlled trial. J Natl Cancer Inst. 2007;99(8):601–7.

    Article  CAS  Google Scholar 

  24. Nitti D, Wils J, Dos Santos JG, Fountzilas G, Conte PF, Sava C, et al. Randomized phase III trials of adjuvant FAMTX or FEMTX compared with surgery alone in resected gastric cancer. A combined analysis of the EORTC GI Group and the ICCG. Ann Oncol Off J Eur Soc Med Oncol. 2006;17(2):262–9.

    Article  CAS  Google Scholar 

  25. Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a systematic review. J Clin Oncol Off J Am Soc Clin Oncol. 2007;25(15):2107–16.

    Article  Google Scholar 

  26. Ajani JA, Mansfield PF, Janjan N, Morris J, Pisters PW, Lynch PM, et al. Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma. J Clin Oncol Off J Am Soc Clin Oncol. 2004;22(14):2774–80.

    Article  CAS  Google Scholar 

  27. Ajani JA, Mansfield PF, Crane CH, Wu TT, Lunagomez S, Lynch PM, et al. Paclitaxel-based chemoradiotherapy in localized gastric carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome. J Clin Oncol Off J Am Soc Clin Oncol. 2005;23(6):1237–44.

    Article  CAS  Google Scholar 

  28. Ajani JA, Winter K, Okawara GS, Donohue JH, Pisters PWT, Crane CH, et al. Phase II trial of preoperative chemoradiation in patients with localized gastric adenocarcinoma (RTOG 9904): quality of combined modality therapy and pathologic response. J Clin Oncol Off J Am Soc Clin Oncol. 2006;24(24):3953–8.

    Article  CAS  Google Scholar 

  29. Lee J, Lim DH, Kim S, Park SH, Park JO, Park YS, et al. Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial. J Clin Oncol Off J Am Soc Clin Oncol. 2012;30(3):268–73.

    Article  CAS  Google Scholar 

  30. National Institutes of Health. Phase III randomized trial of adjuvant chemotherapy with S-1 vs S-1/oxaliplatin ± radiotherapy for completely resected gastric adenocarcinoma: The ARTIST II Trial. [Internet]. 2014 [citato 3 maggio 2018]. Available at: https://clinicaltrials.gov/ct2/show/NCT01761461.

  31. Fuchs CS, Niedzwiecki D, Mamon HJ, Tepper JE, Ye X, Swanson RS, et al. Adjuvant chemoradiotherapy with epirubicin, cisplatin, and fluorouracil compared with adjuvant chemoradiotherapy with fluorouracil and leucovorin after curative resection of gastric cancer: results from CALGB 80101 (Alliance). J Clin Oncol Off J Am Soc Clin Oncol. 2017;35(32):3671–7.

    Article  CAS  Google Scholar 

  32. Cunningham D, Stenning SP, Smyth EC, Okines AF, Allum WH, Rowley S, et al. Peri-operative chemotherapy with or without bevacizumab in operable oesophagogastric adenocarcinoma (UK Medical Research Council ST03): primary analysis results of a multicentre, open-label, randomised phase 2-3 trial. Lancet Oncol. 2017;18(3):357–70.

    Article  CAS  Google Scholar 

  33. Al-Batran S-E, Hofheinz RD, Pauligk C, Kopp H-G, Haag GM, Luley KB, et al. Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol. 2016;17(12):1697–708.

    Article  CAS  Google Scholar 

  34. Frustaci S, Buonadonna A, Turchet E, Corona G, Tabaro G, Miolo G, et al. Phase I trial of docetaxel, oxaliplatin, and capecitabine (DOC) in untreated gastric cancer patients. Int J Clin Oncol. 2013;18(3):510–6.

    Article  CAS  Google Scholar 

  35. Al-Batran SE, Homann N, Schmalenberg H. Perioperative chemotherapy with docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) versus epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/ECX) for resectable gastric or gastroesophageal junction (GEJ) adenocarcinoma (FLOT4-AIO): a multicenter, randomized phase 3 trial. J Clin Oncol. 2017;35(15):4004.

    Article  Google Scholar 

  36. Cats A, Jansen EPM, van Grieken NCT, Sikorska K, Lind P, Nordsmark M, et al. Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (CRITICS): an international, open-label, randomised phase 3 trial. Lancet Oncol. 2018;19(5):616–28.

    Article  CAS  Google Scholar 

  37. Leong T, Smithers BM, Haustermans K, Michael M, Gebski V, Miller D, et al. TOPGEAR: a randomized, phase III trial of perioperative ECF chemotherapy with or without Preoperative Chemoradiation for Resectable Gastric Cancer: interim results from an International, Intergroup Trial of the AGITG, TROG, EORTC and CCTG. Ann Surg Oncol. 2017;24(8):2252–8.

    Article  Google Scholar 

  38. Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 2008;358(1):36–46.

    Article  CAS  Google Scholar 

  39. De Paoli A, Buonadonna A, Turchet E, Cannizzaro R, Canzonieri V, Tumolo S, et al. Neoadjuvant epirubicin, oxaliplatin, capecitabine and radiation therapy (NEOX-RT) followed by surgery for locally advanced gastric cancer (LAGC): interim analysis of a phase II multicentric study. In. ECCO 2013 LBA43 49–3 S19.

    Google Scholar 

  40. Rüdiger Siewert J, Feith M, Werner M, Stein HJ. Adenocarcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in 1,002 consecutive patients. Ann Surg. 2000;232(3):353–61.

    Article  Google Scholar 

  41. Marrelli D, Pedrazzani C, Morgagni P, de Manzoni G, Pacelli F, Coniglio A, et al. Changing clinical and pathological features of gastric cancer over time. Br J Surg. 2011;98(9):1273–83.

    Article  CAS  Google Scholar 

  42. Sjoquist KM, Burmeister BH, Smithers BM, Zalcberg JR, Simes RJ, Barbour A, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. Lancet Oncol. 2011;12(7):681–92.

    Article  Google Scholar 

  43. Ronellenfitsch U, Schwarzbach M, Hofheinz R, Kienle P, Kieser M, Slanger TE, et al. Preoperative chemo(radio)therapy versus primary surgery for gastroesophageal adenocarcinoma: systematic review with meta-analysis combining individual patient and aggregate data. Eur J Cancer. 2013;49(15):3149–58.

    Article  Google Scholar 

  44. Messager M, Lefevre JH, Pichot-Delahaye V, Souadka A, Piessen G, Mariette C, et al. The impact of perioperative chemotherapy on survival in patients with gastric signet ring cell adenocarcinoma: a multicenter comparative study. Ann Surg. 2011;254(5):684–93. discussion 693

    Article  Google Scholar 

  45. Rüschoff J. Adenocarcinoma of the GEJ: gastric or oesophageal cancer? In: Otto F, Lutz MP, editors. Early gastrointestinal cancers. Berlin, Heidelberg: Springer Berlin Heidelberg; 2012. p. 107–13.

    Chapter  Google Scholar 

  46. Mariette C, Piessen G, Briez N, Gronnier C, Triboulet JP. Oesophagogastric junction adenocarcinoma: which therapeutic approach? Lancet Oncol. 2011;12(3):296–305.

    Article  Google Scholar 

  47. De Paoli A, Di Bartolomeo M. Neoadjuvant therapy of gastroesophageal junction adenocarcinoma: chemoradiotherapy or chemotherapy. Eur J Oncol. 2014;19(1):21–3.

    Google Scholar 

  48. van Hagen P, Hulshof MCCM, van Lanschot JJB, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BPL, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074–84.

    Article  Google Scholar 

  49. Burmeister BH, Thomas JM, Burmeister EA, Walpole ET, Harvey JA, Thomson DB, et al. Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase II trial. Eur J Cancer. 2011;47(3):354–60.

    Article  Google Scholar 

  50. Mariette C, Dahan L, Mornex F, Maillard E, Thomas P-A, Meunier B, et al. Surgery alone versus chemoradiotherapy followed by surgery for stage I and II esophageal cancer: final analysis of randomized controlled phase III trial FFCD 9901. J Clin Oncol Off J Am Soc Clin Oncol. 2014;32(23):2416–22.

    Article  CAS  Google Scholar 

  51. Allum WH, Stenning SP, Bancewicz J, Clark PI, Langley RE. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol. 2009;27(30):5062–7.

    Article  Google Scholar 

  52. Kelsen DP, Winter KA, Gunderson LL, Mortimer J, Estes NC, Haller DG, et al. Long-term results of RTOG trial 8911 (USA intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer. J Clin Oncol. 2007;25(24):3719–25.

    Article  Google Scholar 

  53. Shapiro J, van Lanschot JJB, Hulshof MCCM, van Hagen P, van Berge Henegouwen MI, Wijnhoven BPL, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015;16(9):1090–8.

    Article  Google Scholar 

  54. Innocente R, Navarria F, Palazzari E, Matrone F, Boz G, Gigante M, et al. Intensified IMRT with concurrent chemotherapy for locally advanced esophageal carcinoma. In Proceeding ESTRO 2018 PO-0777.

    Google Scholar 

  55. Canzonieri V, Colarossi C, Del Col L, Perin T, Talamini R, Sigon R, et al. Exocrine and endocrine modulation in common gastric carcinoma. Am J Clin Pathol. 2012;137(5):712–21.

    Article  Google Scholar 

  56. Takenaka Y, Tsukamoto T, Mizoshita T, Ogasawara N, Hirano N, Otsuka T, et al. Gastric and intestinal phenotypic correlation between exocrine and endocrine components in human stomach tumors. Histol Histopathol. 2007;22(3):273–84.

    CAS  PubMed  Google Scholar 

  57. Jiang S-X, Mikami T, Umezawa A, Saegusa M, Kameya T, Okayasu I. Gastric large cell neuroendocrine carcinomas: a distinct clinicopathologic entity. Am J Surg Pathol. 2006;30(8):945–53.

    Article  Google Scholar 

  58. Cancer Genome Atlas Research Network. Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513(7517):202–9.

    Article  Google Scholar 

  59. Shah MA, Khanin R, Tang L, Janjigian YY, Klimstra DS, Gerdes H, et al. Molecular classification of gastric cancer: a new paradigm. Clin Cancer Res. 2011;17(9):2693–701.

    Article  CAS  Google Scholar 

  60. Caggiari L, Miolo G, Canzonieri V, De Zorzi M, Alessandrini L, Corona G, et al. A new mutation of the CDH1 gene in a patient with an aggressive signet-ring cell carcinoma of the stomach. Cancer Biol Ther. 2018;19(4):254–9.

    Article  CAS  Google Scholar 

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Acknowledgments

The authors thank S. Flora and D. Michilin for manuscript editing assistance.

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Authors and Affiliations

  1. Radiation Oncology Department, IRCCS, CRO Aviano, National Cancer Institute, Aviano, PN, Italy

    Antonino De Paoli, Federico Navarria, Elisa Palazzari & Roberto Innocente

  2. Surgical Oncology Department, IRCCS, CRO Aviano, National Cancer Institute, Aviano, PN, Italy

    Matteo Olivieri, Claudio Belluco & Giulio Bertola

  3. Medical Oncology Department, IRCCS, CRO Aviano, National Cancer Institute, Aviano, PN, Italy

    Michela Guardascione & Angela Buonadonna

  4. Oncological Gastroenterology Department, IRCCS, CRO Aviano, National Cancer Institute, Aviano, PN, Italy

    Renato Cannizzaro

  5. Pathology Department, IRCCS, CRO Aviano, National Cancer Institute, Aviano, PN, Italy

    Vincenzo Canzonieri

  6. Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, TS, Italy

    Vincenzo Canzonieri

  7. CRO Biobank, IRCCS, CRO Aviano, National Cancer Institute, Aviano, PN, Italy

    Vincenzo Canzonieri

  8. Department of Biology, Temple University, Philadelphia, PA, USA

    Vincenzo Canzonieri

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  1. Antonino De Paoli
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  2. Federico Navarria
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  11. Angela Buonadonna
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Correspondence to Antonino De Paoli .

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Editors and Affiliations

  1. Pathology Unit and Biobank, CRO-Aviano, IRCCS, National Cancer Institute, Aviano, Italy

    Vincenzo Canzonieri

  2. Sbarro Institute for Cancer, Research and Molecular Medicine, Department of Biology, Temple University, Philadelphia, PA, USA

    Antonio Giordano

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De Paoli, A. et al. (2019). Combined Modality Treatment for Locally Advanced Gastric Cancer: Current Evidences and New Perspectives. In: Canzonieri, V., Giordano, A. (eds) Gastric Cancer In The Precision Medicine Era. Current Clinical Pathology. Humana, Cham. https://doi.org/10.1007/978-3-030-04861-7_8

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