A phase II study of neoadjuvant combination chemotherapy with docetaxel, cisplatin, and S-1 for locally advanced resecta
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ORIGINAL ARTICLE
A phase II study of neoadjuvant combination chemotherapy with docetaxel, cisplatin, and S-1 for locally advanced resectable gastric cancer: nucleotide excision repair (NER) as potential chemoresistance marker Masahiro Hirakawa • Yasushi Sato • Hiroyuki Ohnuma • Tetsuji Takayama • Tamotsu Sagawa • Takayuki Nobuoka • Keisuke Harada • Hiroshi Miyamoto • Yasuhiro Sato • Yasuo Takahashi • Shinich Katsuki • Michiaki Hirayama • Minoru Takahashi • Michihiro Ono • Masahiro Maeda • Kohichi Takada • Tsuyoshi Hayashi • Tsutomu Sato • Koji Miyanishi • Rishu Takimoto • Masayoshi Kobune • Koichi Hirata • Junji Kato Received: 9 October 2012 / Accepted: 31 December 2012 / Published online: 22 January 2013 Ó Springer-Verlag Berlin Heidelberg 2013
Abstract Purpose The combination of docetaxel, cisplatin, and S-1 (DCS) chemotherapy is expected to be a promising regimen for advanced gastric cancer. This study was performed to evaluate the efficacy and safety of neoadjuvant DCS chemotherapy for locally advanced resectable gastric cancer. Methods Patients with locally advanced gastric cancer received 2 courses of preoperative chemotherapy with S-1 (40 mg/m2 b.i.d.) on days 1–14 and docetaxel (60 mg/m2) plus cisplatin (60 mg/m2) on day 8 every 3 weeks, followed by standard curative surgery within 4–8 weeks. The primary Masahiro Hirakawa and Yasushi Sato contributed equally to this work.
endpoint was R0 resectability. Expression of damage DNA binding protein complex subunit 2 (DDB2)/excision repair cross-complementing 1 (ERCC1) in the pretreated tumor tissues was examined by immunohistochemistry. Results A total of 43 patients received neoadjuvant chemotherapy. The response rate was 74.4 %, and disease control ratio was 100 %. Grade 4 neutropenia developed in 53.5 % of patients and febrile neutropenia in 16.3 %. Nonhematological grade 3/4 adverse events were anorexia (23.3 %), nausea (14.0 %), and diarrhea (23.3 %), but these were generally transient and manageable. The proportion of R0 resections in the 43 eligible patients was 90.7 %, and a pathological response was found in 65.9 % of patients. There were no treatment-related deaths and no major surgical complications. The accuracy of the
Trial registration ID: UMIN000000801. M. Hirakawa Y. Sato (&) H. Ohnuma K. Takada T. Hayashi T. Sato K. Miyanishi R. Takimoto M. Kobune J. Kato Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan e-mail: [email protected]
S. Katsuki Division of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan
T. Takayama H. Miyamoto Department of Gastroenterology and Oncology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
M. Takahashi Division of Gastroenterology, Sapporo Kyoritsu Gorinbashi Hospital, Sapporo, Japan
T. Sagawa Y. Sato Y. Takahashi Division of Gastroenterology, Hokkaido Cancer Center, Sapporo, Japan
M. Hirayama Division of Gastroenterology, Tonan Hospital, Sapporo,
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