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ANKI- GI > Gastric > Flashcards

Gastric Flashcards

1
Q

What population was studied in the MAGIC study for gastric cancer?

A

503 pts with Resectable stomach/GEJ adenoCA, lower esophagus

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2
Q

What regimen was studied in the MAGIC study for gastric cancer?

A

“<span>→Periop epirubicin, cisplatin and 5-FU (ECF) x3 pre and post-op then surgery</span> <br></br>vs. <br></br>→surgery alone”

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3
Q

What were the results of the MAGIC study for gastric cancer?

A

“<span>5-yr OS 36% chemo vs. 23% <br></br>LR 15% vs. 21%<br></br>No benefit in pathCR<br></br></span><br></br>”

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4
Q

What is the clinical relevance of INT0116 for gastric cancer?

A

This trial showed improved outcomes for gastric cancer with adjuvant chemoRT.

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5
Q

What population was studied in INT0116 for gastric cancer?

A

“603 pts with<span>completely</span> resected stomach (<span>D0 54%, D1 36%, D2 10%</span>) or GE junction adenoCA, <span>85% node positive</span>”

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6
Q

What regimen was studied in INT0116 for gastric cancer?

A

“→obs <br></br>vs. <br></br><span>→5FU/LV x1 → 45 Gy with concurrent 5FU/LV x2 → 5FU/LV x2</span>”

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7
Q

What were the results of INT0116 for gastric cancer?

A

“<div>Adjuvant chemoRT improves OS, RFS, LR, and DM in resected gastric cancer.<span><br></br></span></div><span><div><span><br></br></span></div>3-yr OS 50% vs. 42%<br></br>Median OS 36 mos chemoRT vs. 27 mos<br></br>RFS 48% vs. 31%</span><br></br>LR 19% vs. 29%<br></br>DM 33% vs. 18%<div><br></br></div><div><br></br></div>”

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8
Q

What is the clinical relevance of the CRITICs trial in gastric cancer?

A

Showed no difference in OS with peri-op chemo compared to adjuvant chemoRT in gastric cancer.

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9
Q

What population was studied in the CRITICs trial in gastric cancer?

A

788 pts with Stage IB-IVA gastric or gastric esophageal adenocarcinoma AJCC 6th

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10
Q

What regimen was studied in the CRITICs trial in gastric cancer?

A

ECC or EOC (epirubicin/(cis or ox)/cape) → D1 surg → ECC <br></br>vs. <br></br>→ECC → D1 surg → 45 Gy RT cape/cis<div><br></br></div>

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11
Q

What were the results of the CRITICs trial in gastric cancer?

A

<div>No OS difference but worse heme toxicity with chemo arm.</div>

<div><br></br></div>

5-yr OS ~41% both arms<br></br>Median OS 43 mos vs. 37 mos (p=0.9)<br></br><br></br>Post-op nonfebrile neutropenia 34% vs. 4%

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12
Q

What was the clinical relevance of the ARTIST trial for gastric cancer?

A

Showed that chemo alone can be used adjuvantly for gastric cancer (except for node+ and intestinal subtype).

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13
Q

What population was studied in the ARTIST trial for gastric cancer?

A

458 pts with Stage IB-IVA gastric, East Asia

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14
Q

What regimen was studied in the ARTIST trial for gastric cancer?

A

D2 surgery, R0 →<br></br><br></br>→cape/cis <br></br>vs. <br></br>→cape/cis → RT+cape -→ cape/cis

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15
Q

What were the results of the ARTIST trial for gastric cancer?

A

“Trend to improved DFS ~75% (p=0.09) <br></br>5-yr OS ~75% (NS)<br></br><span>DFS benefit in node positive and intestinal subtype</span>”

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16
Q

What is the clinical relevance of the ARTIST2 trial for gastric cancer?

A

Showed no benefit to adding RT to SOX (chemo) adjuvantly for gastric cancer.

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17
Q

What population was studied in the ARTIST2 trial for gastric cancer?

A

538 pts with Stage II-III gastric, D2 resected, N+

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18
Q

What regimen was studied in the ARTIST2 trial for gastric cancer?

A

→S1 vs.<br></br>→S1+oxaliplatin vs.<br></br>→S1+oxaliplatin+45 Gy RT

19
Q

What were the results of the ARTIST2 trial for gastric cancer?

A

Trial stopped early due to futility<br></br>No difference in OS for SOX vs. SOXRT (p=0.057)<br></br>3-yr DFS 78% vs. 73%

20
Q

What was the clinical relevance of RTOG 9904 for gastric cancer?

A

Explored neoadjuvant chemoRT for gastric cancer. Showed favorable results. Currently being evaluated in TOPGEAR study.

21
Q

What population was studied in RTOG 9904 for gastric cancer?

A

49 pts with localized gastric adenocarcinoma

22
Q

What regimen was studied in RTOG 9904 for gastric cancer?

A

Phase II: pre-op cis/5FU x2 → concurrent chemoRT 45 Gy with 5FU and weekly taxol → resection

23
Q

What were the results of RTOG 9904 for gastric cancer?

A

<div>Favorable results:</div>

<div><br></br></div>

pCR 26%, 1 yr OS 72%, Median OS 23 mos<br></br><br></br>If pCR, then 1 yr OS 82%

24
Q

What was the clinical relevance of CALGB 80101 for gastric cancer?

A

Showed that ECF with RT has less toxicity than 5FU with RT for adjuvant gastric cancer treatment.

25
Q

What population was studied in CALGB 80101 for gastric cancer?

A

546 pts with resected Stage IB-IV(M0) gastric adenocarcinoma

26
Q

What regimen was studied in CALGB 80101 for gastric cancer?

A

→5FU/LV → RT/5FU → 5FU/LV<br></br>vs.<br></br>→ECF → RT/5FU → ECF

27
Q

What were the results of CALGB 80101 for gastric cancer?

A

“<span>No change in OS, but less toxicity with ECF–>RT</span><br></br><br></br><div>Median OS ~37 mos, 5-yr OS 44%<br></br><br></br>With ECF, less diarrhea, mucositis, dehydration, and neutropenia</div>”

28
Q

What was the clinical relevance of the FLOT4 study for gastric cancer?

A

Showed that perioperative FLOT improved survival over ECF/ECX.

29
Q

What population was studied in the FLOT4 study for gastric cancer?

A

“716 pts with Gastric or GEJ adenocarcinoma stage ≥cT2 or N+<br></br><br></br><span>(44% gastric, 56% GEJ, 80% N+)</span>”

30
Q

What regimen was studied in the FLOT4 study for gastric cancer?

A

“→periop <span>FLOT</span> (docetaxel, oxaliplatin, 5-FU, LV) (D2 dissections)<br></br>vs. <br></br>→ECF or ECX”

31
Q

What were the results of the FLOT4 study for gastric cancer?

A

“<span>OS improved with FLOT</span><br></br>Median OS 50 mos vs. 35 mos<br></br>5-yr OS 45% vs. 36%<br></br>DFS 30 mos vs. 18 mos<div><br></br>Toxicity similar. Like ECF, FLOT4 is poorly tolerated with 46% completion</div>”

32
Q

What was the clinical relevance of the South Korean adjuvant RT for gastric cancer study (Kim, IJROBP 2005)?

A

Showed that adjuvant chemoRT improves OS for D2 dissected gastric cancer

33
Q

What population was studied in the South Korean adjuvant RT for gastric cancer study (Kim, IJROBP 2005)?

A

544 pts with D2 dissection

34
Q

What regimen was studied in the South Korean adjuvant RT for gastric cancer study (Kim, IJROBP 2005)?

A

→Observational. D2 surgery alone <br></br>vs. <br></br>→D2 surgery with 45 Gy RT + 5FU

35
Q

What were the results of the South Korean adjuvant RT for gastric cancer study (Kim, IJROBP 2005)?

A

Improved OS and PFS with adjuvant chemoRT.<div><br></br></div><div>Median OS 95 mos vs. 63 mos</div><div>PFS 75 mos vs. 52 mos</div>

36
Q

What is the clinical relevance of the ACTS-GC trial for gastric cancer?

A

Showed that adjuvant S1 (oral 5-FU) improved OS in gastric cancer

37
Q

What population was studied in the ACTS-GC trial for gastric cancer?

A

529 pts with Stage II-III gastric, East Asia

38
Q

What regimen was studied in the ACTS-GC trial for gastric cancer?

A

“D2 surgery → <br></br><span>→S1 for one year </span>vs.<br></br><span>→</span>obs”

39
Q

What were the results of the ACTS-GC trial for gastric cancer?

A

3-yr OS improved with adjuvant S1<div>80% vs. 70%</div>

40
Q

What was the clinical relevance of the CLASSIC trial for gastric cancer?

A

This trial showed that adjuvant Cape/Ox improved outcomes for gastric cancer

41
Q

What population was studied in the CLASSIC trial for gastric cancer?

A

1035 pts with Stage II-IIIB gastric, East Asia. Patients in South Koreea, China, and Taiwan

42
Q

What regimen was studied in the CLASSIC trial for gastric cancer?

A

“D2 gastrectomy → <br></br><span>→cape/ox</span> <br></br>vs. <br></br>→obs”

43
Q

What were the results of the CLASSIC trial for gastric cancer?

A

<div>Improved OS and DFS with adjuvant Cape/Ox</div>

<div><br></br></div>

5-yr DFS 68% vs. 53%<br></br>5-yr OS 78% vs. 69%

ANKI- GI (8 decks)

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