{Reference Type}: Journal Article
{Title}: Docetaxel-oxaliplatin-capecitabine/5-fluorouracil (DOX/F) followed by docetaxel versus oxaliplatin-capecitabine/5-fluorouracil (CAPOX/FOLFOX) in HER2-negative advanced gastric cancers.
{Author}: Ramaswamy A;Bhargava P;Dubashi B;Gupta A;Kapoor A;Srinivas S;Shetty O;Jadhav P;Desai V;Noronha V;Joshi A;Menon N;Patil VM;Mishra BK;Sansar B;Singh A;Patel S;Singh SN;Dhal I;Vinayak KR;Pal V;Mandavkar S;Kannan S;Chaugule D;Patil R;Parulekar M;Nashikkar C;Ankathi SK;Kaushal RK;Shah A;Ganesan P;Kayal S;Ananthakrishnan R;Syed N;Samaddar D;Kapu V;Shah A;Kaaviya D;Suganiya R;Srinivasan ND;Prabhash K;Ostwal V;
{Journal}: JNCI Cancer Spectr
{Volume}: 8
{Issue}: 4
{Year}: 2024 Jul 1
暂无{DOI}: 10.1093/jncics/pkae054
{Abstract}: <B>BACKGROUND: </B>We evaluated whether the addition of docetaxel (D) to a combination comprising 5-fluorouracil/leucovorin (5-FU/LV) or capecitabine (C) plus oxaliplatin (O) (DOF/DOX) improved overall survival (OS) compared with 6 months of 5-fluorouracil (5-FU) or capecitabine in combination with oxaliplatin (FOLFOX/CAPOX) alone in advanced HER2-negative gastroesophageal junction and gastric adenocarcinomas (G/GEJ).<BR><B>METHODS: </B>This study was an investigator-initiated, open-label, multi-institutional, randomized phase III trial in adult patients with HER2-negative advanced G/GEJs. The primary endpoint of the study was a comparison of median OS by Kaplan-Meier method. Next-generation sequencing was performed on tissue.<BR><B>RESULTS: </B>Of the 324 patients randomly assigned between July 2020 and November 2022, 305 patients were evaluable for analysis (FOLFOX/CAPOX: 156; DOF/DOX: 149). With a median follow-up time of 19.2 months (95% Confidence Interval [CI] = 16.5 months to 21.9 months) for the entire cohort, the median OS was 10.1 months (95% CI = 9.2 to 10.9) for FOLFOX/CAPOX and 8.9 months (95% CI = 7.3 to 10.5) for DOF/DOX, and this difference was not statistically significant (P = .70). An increased proportion of grade 3 or grade 4 neutropenia (21% vs 3%; P < .001) and grade 2/3 neuropathy (17% vs 7%; P = .005) was seen in patients receiving DOF/DOX. Genomic profiling revealed a low incidence of microsatellite instability (1%) and a high incidence of BRCA1 (8.4%) and BRCA2 (7.5%) somatic alterations.<BR><B>CONCLUSIONS: </B>FOLFOX or CAPOX chemotherapy for 6 months remains one of the standards of care in advanced HER2-negative gastroesophageal junction and gastric adenocarcinomas, with no additional survival benefit seen with the addition of docetaxel. Genomic profiling of patients revealed a higher than previously known incidence of somatic BRCA alterations, which requires further evaluation.CTRI (Clinical Trial Registry of India: CTRI/2020/03/023944).