Response to neoadjuvant chemotherapy in locally advanced gastric and gastroesophageal cancer: Phase II clinical trial

Background: Gastric cancer is an important health problem across the world. Chemotherapy in combina on with local treatment is standard treatment for locally advanced gastroesophageal cancers. The purpose of this inves ga on was evalua on of response and tolerability to neoadjuvant EOX regimen in locoregionally advanced gastric cancer. Materials and Methods: pa ents with locoregionally advanced gastric or EG junc on adenocarcinoma enrolled in this study. Staging workup including chest and abdominal computed tomography (CT) scan, upper GI endoscopy, endoscopic ultrasonography (EUS), CEA, CBC, liver and renal func on test were done. A)er treatment with 3 cycles of EOX regimen, endoscopic ultrasonography (EUS) and chest and abdominal CT scan was done to evaluate the response to neoadjuant chemotherapy. Results: The age of pa ents ranged from 37 to 78 years, with a mean age of 56.6 (SD=11.8). before chemotherapy, most pa ents were classified as stage III (98.8%) and a)er chemotherapy, most pa ents were classified as stage II (57.14%). only 28.5% of tumors were resectable before chemotherapy, but a)er chemotherapy 82.1% of tumors were resectable. 75% of tumors were downstaged a)er chemotherapy. Conclusion: With regard to acceptable response and downstaging of tumors and less toxicity with EOX regimen in locoregionally advanced gastric cancer, it seems that evalua on of this regimen as neoadjuvant chemotherapy in more advanced phase III clinical trial is necessary and logical.