title: Phase II study of neo-adjuvant chemotherapy for locally advanced gastric cancer.
abstract: BACKGROUND
  Neoadjuvant chemotherapy improves survival of locally advanced gastric cancer patients. However, benefit is limited and the best regimen remains controversial.
  
  
  OBJECTIVE
  Our primary objective of this prospective, multicenter phase 2 study was to evaluate the pathological complete response rate (PCR) with 2 cycles of docetaxel and capecitabine.
  
  
  METHODS
  To be eligible, patients had to have histologically documented gastric cancer, a ECOG performance status 0 or 1, T3or4 Nany M0 staging after oesophagogastroduodenoscopy (OGD), endoscopic ultrasound (EUS), CT scan of thorax and abdomen, and negative laparoscopic examination and peritoneal washing. Eligible patients received two cycles of intravenous docetaxel 60 mg/m(2) on day 1 and oral capecitabine 900 mg/m(2) two times per day from day 1 to day 14 every 3 weeks. We evaluated the response by CT scan and EUS. The patients underwent curative resection with D2 lymphadenectomy subsequently.
  
  
  RESULTS
  18 patients were enrolled in the study: 66% were male and the median age was 60 years. 17 patients had T3 disease at diagnosis. There was no pCR noted. 4 patients had a partial response of 22% (95% CI: 7-42%), 8 patients had stable disease and 3 patients had disease progression. The median survival was 17.1 months with 3 long-term survivors after at least 3 years of follow-up. The treatment was well tolerated with neutropenia being the most common toxicity. We observed 22% grade III and 33% grade IV neutropenia, but no neutropenic fever or death was observed from chemotherapy.
  
  
  CONCLUSIONS
  Neo-adjuvant chemotherapy with docetaxel and capecitabine has limited activity against GC. More effective treatment regimens are needed urgently.
  
  
  BACKGROUND
  NCT00414271.
authors.affiliation: Department of Medical Oncology , Johns Hopkins Singapore , Singapore.
authors.forename: Alex Yuang-Chi
authors.initials: AY
authors.lastname: Chang
authors.affiliation: Department of Medical Oncology , National Cancer Centre , Singapore.
authors.forename: Kian Fong
authors.initials: KF
authors.lastname: Foo
authors.affiliation: Department of Medical Oncology , National Cancer Centre , Singapore.
authors.forename: Wen-Hsin
authors.initials: WH
authors.lastname: Koo
authors.affiliation: Department of Medical Oncology , National Cancer Centre , Singapore.
authors.forename: Simon
authors.initials: S
authors.lastname: Ong
authors.affiliation: Department of Surgery , National University Hospital , Singapore.
authors.forename: Jimmy
authors.initials: J
authors.lastname: So
authors.affiliation: Department of Surgery , Alexandra Hospital , Singapore.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tan
authors.affiliation: Department of Surgery , Tan Tock Seng Hospital , Singapore.
authors.forename: Khong Hee
authors.initials: KH
authors.lastname: Lim
keywords: CHEMOTHERAPY; GASTRIC ADENOCARCINOMA; GASTRIC SURGERY