CLASSIC

Summary:

  • What are the effects of having chemotherapy after surgery? This trial compared two groups patients having a gastrectomy. One group was given chemotherapy after surgery. The other group was not. The drugs studied were capecitabine and oxaliplatin. The researchers measured the survival of patients and the recurrence of cancer. They found that the chemotherapy was helpful.

Link:

Citation:

  • Noh, Sung Hoon, et al. “Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): 5-year follow-up of an open-label, randomised phase 3 trial.” The lancet oncology 15.12 (2014): 1389-1396. Available from: doi: doi.org/10.1016/S1470-2045(14)70473-5.

Where?

  • Korea

When?

  • Published 2014

Impact Factor (IF):

  • 33.990

A gastrectomy can sometimes be used to treat gastric cancer. Surgery works by removing the tumor. Chemotherapy medication can be given before and/or after surgery. The main goal of having chemotherapy after surgery is to make sure that the cancer does not come back. It can also prevent any leftover cancer cells from spreading to other parts of the body. This trial compared the results of giving chemotherapy after surgery to surgery alone.

The participants in this experiment were patients with Stage II or III gastric cancer. All patients had a D2 gastrectomy surgery. This means that the part of the stomach with the tumor was removed as well as many lymph nodes in the area. After surgery, patients were randomly assigned to a treatment group:

Group A patients did not receive treatment after surgery. They were observed as the control group.

Group B patients received chemotherapy after surgery. Their medications were capecitabine and oxaliplatin:

  • Capecitabine: prevents cancer cells from being able to divide properly. This was taken as a pill.
  • Oxaliplatin: stops the genetic material in cancer cells from copying properly. This was given intravenously.

These medications were given over 8 three-week cycles starting soon after surgery. So, Group B was scheduled to have 24 weeks of chemotherapy in total.

Results: The chemotherapy group had much better results than the patients who just had surgery. Times for overall survival were longer in Group B. This means that patients who had chemotherapy after surgery were living longer in general. Also, Group B patients had a longer time of disease-free survival. This means that they lived longer without a relapse of cancer. The participants were studied for about 5 years. At this time, researchers were able to estimate the overall 5-year survival of the patients. For group A, survival was 69%. For group B, survival was 78%. This number represents the percent of the original participants in each group who were alive after 5 years. So, this study showed the benefits of having oxaliplatin and capecitabine chemotherapy after surgery for patients with gastric cancer.