- Preoperative chemotherapy, surgery, and postoperative chemoradiotherapy does not improve OS compared with perioperative chemotherapy and surgery in patients with resectable gastric cancer (GC).
Why this matters
- Preoperative chemotherapy, surgery, and postoperative chemoradiotherapy is the standard treatment for resectable GC in the United States, based on findings from a 2001 study, while perioperative chemotherapy and surgery is the preferred treatment in Europe, based on results of a 2006 study.
- The authors of an accompanying commentary suggest that these new findings point to a limited role for chemoradiotherapy in resectable GC.
- Open-label, randomized, phase 3, multicenter, international CRITICS trial.
- 788 patients with resectable GC received perioperative chemotherapy (chemotherapy group; n=393) or preoperative chemotherapy with postoperative chemoradiotherapy (chemoradiotherapy group; n=395).
- Funding: Dutch Cancer Society and others.
- 95% of chemotherapy group and 93% of chemoradiotherapy group underwent surgery.
- 233 patients initiated postoperative chemotherapy and 245 patients initiated postoperative chemoradiotherapy, respectively.
- 43 months median OS in chemotherapy group vs 37 months in chemoradiotherapy group (HR, 1.01; 95% CI, 0.84-1.22).
- Overall, 98% of patients reported adverse events (AEs) during preoperative therapy.
- Postoperative AEs similar between groups.
- Some patients had no postoperative treatment.