Clinical Edge Journal Scan

Key clinical point: Statin exposure reduces the risk for and improves the prognosis of gastric cancer.

Major finding: The statin-exposed vs -nonexposed population showed a significantly reduced incidence (odds ratio [OR] 0.78; P < .001) and improved prognosis (OR 0.78; P = .002) of gastric cancer.

Study details: This was a meta-analysis of 19 studies that analyzed the correlation between statin exposure and the occurrence and progression of gastric cancer.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Lou D et al. Association between statins' exposure with incidence and prognosis of gastric cancer: An updated meta-analysis. Expert Rev Clin Pharmacol. 2022; 1-12 (Aug 15). Doi: 10.1080/17512433.2022.2112178

Key clinical point: Statin exposure reduces the risk for and improves the prognosis of gastric cancer.

Major finding: The statin-exposed vs -nonexposed population showed a significantly reduced incidence (odds ratio [OR] 0.78; P < .001) and improved prognosis (OR 0.78; P = .002) of gastric cancer.

Study details: This was a meta-analysis of 19 studies that analyzed the correlation between statin exposure and the occurrence and progression of gastric cancer.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Lou D et al. Association between statins' exposure with incidence and prognosis of gastric cancer: An updated meta-analysis. Expert Rev Clin Pharmacol. 2022; 1-12 (Aug 15). Doi: 10.1080/17512433.2022.2112178

Key clinical point: Statin exposure reduces the risk for and improves the prognosis of gastric cancer.

Major finding: The statin-exposed vs -nonexposed population showed a significantly reduced incidence (odds ratio [OR] 0.78; P < .001) and improved prognosis (OR 0.78; P = .002) of gastric cancer.

Study details: This was a meta-analysis of 19 studies that analyzed the correlation between statin exposure and the occurrence and progression of gastric cancer.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Lou D et al. Association between statins' exposure with incidence and prognosis of gastric cancer: An updated meta-analysis. Expert Rev Clin Pharmacol. 2022; 1-12 (Aug 15). Doi: 10.1080/17512433.2022.2112178

Key clinical point: The presence of myosteatosis along with increased systemic inflammatory response markers, such as neutrophil-to-lymphocyte ratio (NLR), serves as an independent prognostic indicator in patients with resectable gastric cancer.

Major finding: Co-occurrence of myosteatosis and an NLR of > 2.3 was significantly associated with worse disease-free survival (hazard ratio [HR] 2.77; P = .001) and overall survival (HR 3.31; P < .001).

Study details: This single-center retrospective observational study included 280 patients with gastric cancer who underwent total or partial gastrectomy with curative intent.

Disclosures: This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo and Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil. The authors declared no conflicts of interest.

Source: Lascala F et al. Prognostic value of myosteatosis and systemic inflammation in patients with resectable gastric cancer: A retrospective study. Eur J Clin Nutr. 2022 (Sep 8). Doi: 10.1038/s41430-022-01201-7

Key clinical point: The presence of myosteatosis along with increased systemic inflammatory response markers, such as neutrophil-to-lymphocyte ratio (NLR), serves as an independent prognostic indicator in patients with resectable gastric cancer.

Major finding: Co-occurrence of myosteatosis and an NLR of > 2.3 was significantly associated with worse disease-free survival (hazard ratio [HR] 2.77; P = .001) and overall survival (HR 3.31; P < .001).

Study details: This single-center retrospective observational study included 280 patients with gastric cancer who underwent total or partial gastrectomy with curative intent.

Disclosures: This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo and Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil. The authors declared no conflicts of interest.

Source: Lascala F et al. Prognostic value of myosteatosis and systemic inflammation in patients with resectable gastric cancer: A retrospective study. Eur J Clin Nutr. 2022 (Sep 8). Doi: 10.1038/s41430-022-01201-7

Key clinical point: The presence of myosteatosis along with increased systemic inflammatory response markers, such as neutrophil-to-lymphocyte ratio (NLR), serves as an independent prognostic indicator in patients with resectable gastric cancer.

Major finding: Co-occurrence of myosteatosis and an NLR of > 2.3 was significantly associated with worse disease-free survival (hazard ratio [HR] 2.77; P = .001) and overall survival (HR 3.31; P < .001).

Study details: This single-center retrospective observational study included 280 patients with gastric cancer who underwent total or partial gastrectomy with curative intent.

Disclosures: This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo and Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil. The authors declared no conflicts of interest.

Source: Lascala F et al. Prognostic value of myosteatosis and systemic inflammation in patients with resectable gastric cancer: A retrospective study. Eur J Clin Nutr. 2022 (Sep 8). Doi: 10.1038/s41430-022-01201-7

Key clinical point: A shorter gastric observation time during index esophagogastroduodenoscopy (EGD; preceding gastric cancer diagnosis) serves as an important predictor of the occurrence of interval advanced gastric cancer.

Major finding: A shorter observation time (<3 min; adjusted odds ratio 2.27;  95% CI 1.20-4.30) at preceding endoscopy was independently associated with an increased risk for interval advanced gastric cancer.

Study details: Findings are from a retrospective nested case-control study that included 1257 patients diagnosed with gastric cancer within 6-36 months of “cancer-negative” index EGD, of which 102 patients had advanced gastric cancer.

Disclosures: This study was supported by the Research Fund of the Korean Society of Gastroenterology and a National Research Foundation of Korea grant funded by the Korea government. The authors declared no conflicts of interest.

Source: Kim TJ et al. Interval advanced gastric cancer after negative endoscopy. Clin Gastroenterol Hepatol. 2022 (Sep 5). Doi: 10.1016/j.cgh.2022.08.027

Key clinical point: A shorter gastric observation time during index esophagogastroduodenoscopy (EGD; preceding gastric cancer diagnosis) serves as an important predictor of the occurrence of interval advanced gastric cancer.

Major finding: A shorter observation time (<3 min; adjusted odds ratio 2.27;  95% CI 1.20-4.30) at preceding endoscopy was independently associated with an increased risk for interval advanced gastric cancer.

Study details: Findings are from a retrospective nested case-control study that included 1257 patients diagnosed with gastric cancer within 6-36 months of “cancer-negative” index EGD, of which 102 patients had advanced gastric cancer.

Disclosures: This study was supported by the Research Fund of the Korean Society of Gastroenterology and a National Research Foundation of Korea grant funded by the Korea government. The authors declared no conflicts of interest.

Source: Kim TJ et al. Interval advanced gastric cancer after negative endoscopy. Clin Gastroenterol Hepatol. 2022 (Sep 5). Doi: 10.1016/j.cgh.2022.08.027

Key clinical point: A shorter gastric observation time during index esophagogastroduodenoscopy (EGD; preceding gastric cancer diagnosis) serves as an important predictor of the occurrence of interval advanced gastric cancer.

Major finding: A shorter observation time (<3 min; adjusted odds ratio 2.27;  95% CI 1.20-4.30) at preceding endoscopy was independently associated with an increased risk for interval advanced gastric cancer.

Study details: Findings are from a retrospective nested case-control study that included 1257 patients diagnosed with gastric cancer within 6-36 months of “cancer-negative” index EGD, of which 102 patients had advanced gastric cancer.

Disclosures: This study was supported by the Research Fund of the Korean Society of Gastroenterology and a National Research Foundation of Korea grant funded by the Korea government. The authors declared no conflicts of interest.

Source: Kim TJ et al. Interval advanced gastric cancer after negative endoscopy. Clin Gastroenterol Hepatol. 2022 (Sep 5). Doi: 10.1016/j.cgh.2022.08.027

Key clinical point: Laparoscopic proximal gastrectomy (LPG) and laparoscopic total gastrectomy (LTG) lead to similar long-term outcomes and postoperative complications in patients with upper third clinical stage I gastric cancer.

Major finding: Patients who underwent LPG and LTG showed no significant difference in the 3-year overall survival (92.6% and 92.3%, respectively; P = .74), recurrence-free survival (both 85.3%; P = .72), early complication (eg, surgical site infection; P = .31), and late complication (eg, anastomotic stenosis; P = .31) rates.

Study details: This retrospective study propensity score-matched patients with upper third clinical stage I gastric cancer who underwent LTG (n = 28) and those who underwent LPG (n = 28).

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Yamamoto M et al. Laparoscopic proximal gastrectomy with novel valvuloplastic esophagogastrostomy vs laparoscopic total gastrectomy for stage I gastric cancer: A propensity score matching analysis. J Gastrointest Surg. 2022 (Aug 29). Doi: 10.1007/s11605-022-05404-y

Key clinical point: Laparoscopic proximal gastrectomy (LPG) and laparoscopic total gastrectomy (LTG) lead to similar long-term outcomes and postoperative complications in patients with upper third clinical stage I gastric cancer.

Major finding: Patients who underwent LPG and LTG showed no significant difference in the 3-year overall survival (92.6% and 92.3%, respectively; P = .74), recurrence-free survival (both 85.3%; P = .72), early complication (eg, surgical site infection; P = .31), and late complication (eg, anastomotic stenosis; P = .31) rates.

Study details: This retrospective study propensity score-matched patients with upper third clinical stage I gastric cancer who underwent LTG (n = 28) and those who underwent LPG (n = 28).

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Yamamoto M et al. Laparoscopic proximal gastrectomy with novel valvuloplastic esophagogastrostomy vs laparoscopic total gastrectomy for stage I gastric cancer: A propensity score matching analysis. J Gastrointest Surg. 2022 (Aug 29). Doi: 10.1007/s11605-022-05404-y

Key clinical point: Laparoscopic proximal gastrectomy (LPG) and laparoscopic total gastrectomy (LTG) lead to similar long-term outcomes and postoperative complications in patients with upper third clinical stage I gastric cancer.

Major finding: Patients who underwent LPG and LTG showed no significant difference in the 3-year overall survival (92.6% and 92.3%, respectively; P = .74), recurrence-free survival (both 85.3%; P = .72), early complication (eg, surgical site infection; P = .31), and late complication (eg, anastomotic stenosis; P = .31) rates.

Study details: This retrospective study propensity score-matched patients with upper third clinical stage I gastric cancer who underwent LTG (n = 28) and those who underwent LPG (n = 28).

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Yamamoto M et al. Laparoscopic proximal gastrectomy with novel valvuloplastic esophagogastrostomy vs laparoscopic total gastrectomy for stage I gastric cancer: A propensity score matching analysis. J Gastrointest Surg. 2022 (Aug 29). Doi: 10.1007/s11605-022-05404-y

Key clinical point: Modern perioperative chemotherapy (PC) combined with minimally invasive surgery (MIS) improves lymph node yield and long-term survival without affecting postoperative morbidity in operable gastric cancer.

Major finding: Compared with surgery in 2005-2010, that in 2016-2021 and 2011-2015 was associated with adjusted hazard ratios (95% CI) for overall 3-year mortality of 0.37 (0.20-0.68) and 1.02 (0.63-1.66), respectively. Surgery in 2016-2021 vs 2005-2010 led to significantly increased median lymph node yield (23 vs 17; P < .001) but similar major complication rates (15.5% vs 12.3%; P = .736).

Study details: This real-world retrospective study included 181 patients with gastric or esophagogastric junction adenocarcinoma who underwent curative intent surgery in years 2005-2010 (open surgery+adjuvant therapy; n = 65), 2011-2015 (PC+MIS adopted; n = 58), and 2016-2021 (PC+MIS standard practice; n = 58).

Disclosures: This study was sponsored by the Instrumentarium Science Foundation, Helsinki, Finland, among others. The authors declared no conflicts of interest.

Source: Junttila A et al. Implementation of multimodality therapy and minimally invasive surgery: Short- and long-term outcomes of gastric cancer surgery in medium-volume center. J Gastrointest Surg. 2022 (Aug 24). Doi: 10.1007/s11605-022-05437-3

Key clinical point: Modern perioperative chemotherapy (PC) combined with minimally invasive surgery (MIS) improves lymph node yield and long-term survival without affecting postoperative morbidity in operable gastric cancer.

Major finding: Compared with surgery in 2005-2010, that in 2016-2021 and 2011-2015 was associated with adjusted hazard ratios (95% CI) for overall 3-year mortality of 0.37 (0.20-0.68) and 1.02 (0.63-1.66), respectively. Surgery in 2016-2021 vs 2005-2010 led to significantly increased median lymph node yield (23 vs 17; P < .001) but similar major complication rates (15.5% vs 12.3%; P = .736).

Study details: This real-world retrospective study included 181 patients with gastric or esophagogastric junction adenocarcinoma who underwent curative intent surgery in years 2005-2010 (open surgery+adjuvant therapy; n = 65), 2011-2015 (PC+MIS adopted; n = 58), and 2016-2021 (PC+MIS standard practice; n = 58).

Disclosures: This study was sponsored by the Instrumentarium Science Foundation, Helsinki, Finland, among others. The authors declared no conflicts of interest.

Source: Junttila A et al. Implementation of multimodality therapy and minimally invasive surgery: Short- and long-term outcomes of gastric cancer surgery in medium-volume center. J Gastrointest Surg. 2022 (Aug 24). Doi: 10.1007/s11605-022-05437-3

Key clinical point: Modern perioperative chemotherapy (PC) combined with minimally invasive surgery (MIS) improves lymph node yield and long-term survival without affecting postoperative morbidity in operable gastric cancer.

Major finding: Compared with surgery in 2005-2010, that in 2016-2021 and 2011-2015 was associated with adjusted hazard ratios (95% CI) for overall 3-year mortality of 0.37 (0.20-0.68) and 1.02 (0.63-1.66), respectively. Surgery in 2016-2021 vs 2005-2010 led to significantly increased median lymph node yield (23 vs 17; P < .001) but similar major complication rates (15.5% vs 12.3%; P = .736).

Study details: This real-world retrospective study included 181 patients with gastric or esophagogastric junction adenocarcinoma who underwent curative intent surgery in years 2005-2010 (open surgery+adjuvant therapy; n = 65), 2011-2015 (PC+MIS adopted; n = 58), and 2016-2021 (PC+MIS standard practice; n = 58).

Disclosures: This study was sponsored by the Instrumentarium Science Foundation, Helsinki, Finland, among others. The authors declared no conflicts of interest.

Source: Junttila A et al. Implementation of multimodality therapy and minimally invasive surgery: Short- and long-term outcomes of gastric cancer surgery in medium-volume center. J Gastrointest Surg. 2022 (Aug 24). Doi: 10.1007/s11605-022-05437-3

Key clinical point: Lymph node ratio (LNR) may serve as an independent prognosis predictor in patients with locally advanced gastric cancer (LAGC) after neoadjuvant chemotherapy (NACT).

Major finding: Patients with a low vs high LNR had significantly longer 3-year overall survival (OS; 81.9% vs 18.5%; P < .001) and progression-free survival (PFS; 72.6% vs 13.5%; P < .001) rates. Multivariate analysis revealed LNR to be the only independent predictive factor for both OS (adjusted hazard ratio [aHR] 6.90; P < .001) and PFS (aHR 5.58; P < .001).

Study details: This retrospective study included 148 patients with LAGC who underwent NACT and radical gastrectomy and were categorized to have a low (≤30%; n = 103) or high (>30%; n = 45) LNR.

Disclosures: This study was sponsored by the National Natural Science Foundation of China and the Natural Science Foundation of Hubei Province. The authors declared no conflicts of interest.

Source: Jiang Q et al. Lymph node ratio is a prospective prognostic indicator for locally advanced gastric cancer patients after neoadjuvant chemotherapy. World J Surg Oncol. 2022;20(1):261 (Aug 17). Doi: 10.1186/s12957-022-02725-9

Key clinical point: Lymph node ratio (LNR) may serve as an independent prognosis predictor in patients with locally advanced gastric cancer (LAGC) after neoadjuvant chemotherapy (NACT).

Major finding: Patients with a low vs high LNR had significantly longer 3-year overall survival (OS; 81.9% vs 18.5%; P < .001) and progression-free survival (PFS; 72.6% vs 13.5%; P < .001) rates. Multivariate analysis revealed LNR to be the only independent predictive factor for both OS (adjusted hazard ratio [aHR] 6.90; P < .001) and PFS (aHR 5.58; P < .001).

Study details: This retrospective study included 148 patients with LAGC who underwent NACT and radical gastrectomy and were categorized to have a low (≤30%; n = 103) or high (>30%; n = 45) LNR.

Disclosures: This study was sponsored by the National Natural Science Foundation of China and the Natural Science Foundation of Hubei Province. The authors declared no conflicts of interest.

Source: Jiang Q et al. Lymph node ratio is a prospective prognostic indicator for locally advanced gastric cancer patients after neoadjuvant chemotherapy. World J Surg Oncol. 2022;20(1):261 (Aug 17). Doi: 10.1186/s12957-022-02725-9

Key clinical point: Lymph node ratio (LNR) may serve as an independent prognosis predictor in patients with locally advanced gastric cancer (LAGC) after neoadjuvant chemotherapy (NACT).

Major finding: Patients with a low vs high LNR had significantly longer 3-year overall survival (OS; 81.9% vs 18.5%; P < .001) and progression-free survival (PFS; 72.6% vs 13.5%; P < .001) rates. Multivariate analysis revealed LNR to be the only independent predictive factor for both OS (adjusted hazard ratio [aHR] 6.90; P < .001) and PFS (aHR 5.58; P < .001).

Study details: This retrospective study included 148 patients with LAGC who underwent NACT and radical gastrectomy and were categorized to have a low (≤30%; n = 103) or high (>30%; n = 45) LNR.

Disclosures: This study was sponsored by the National Natural Science Foundation of China and the Natural Science Foundation of Hubei Province. The authors declared no conflicts of interest.

Source: Jiang Q et al. Lymph node ratio is a prospective prognostic indicator for locally advanced gastric cancer patients after neoadjuvant chemotherapy. World J Surg Oncol. 2022;20(1):261 (Aug 17). Doi: 10.1186/s12957-022-02725-9

Key clinical point: A reduction in the treatment cycle number of adjuvant chemotherapy with S-1 (Tegafur+ 5-chloro-2-4-dihydroxypyridine+oxonic acid) or capecitabine/oxaliplatin (CAPOX) in gastric cancer results in poorer survival outcomes.

Major finding: The 5-year overall survival rates in patients who received S-1 gradually increased from 48.4% to 55.4%, 64.1%, 71.1%, and 77.9% with an increase in cycle number from ≤5 to ≥8 cycles (P < .0001), with the same trend being observed with CAPOX (≤4 to ≥8 cycles: 43.5%, 45.3%, 47.1%, 55.3%, and 67.2%; P < .0001).

Study details: This retrospective study included 20,552 patients with gastric cancer who received 12-month S-1 (n = 13,614) or 6-month CAPOX (n = 6938) adjuvant chemotherapy.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kim TH et al. Analysis of treatment outcomes according to the cycles of adjuvant chemotherapy in gastric cancer: A retrospective nationwide cohort study. BMC Cancer. 2022;22(1):948 (Sep 3). Doi: 10.1186/s12885-022-10006-7

Key clinical point: A reduction in the treatment cycle number of adjuvant chemotherapy with S-1 (Tegafur+ 5-chloro-2-4-dihydroxypyridine+oxonic acid) or capecitabine/oxaliplatin (CAPOX) in gastric cancer results in poorer survival outcomes.

Major finding: The 5-year overall survival rates in patients who received S-1 gradually increased from 48.4% to 55.4%, 64.1%, 71.1%, and 77.9% with an increase in cycle number from ≤5 to ≥8 cycles (P < .0001), with the same trend being observed with CAPOX (≤4 to ≥8 cycles: 43.5%, 45.3%, 47.1%, 55.3%, and 67.2%; P < .0001).

Study details: This retrospective study included 20,552 patients with gastric cancer who received 12-month S-1 (n = 13,614) or 6-month CAPOX (n = 6938) adjuvant chemotherapy.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kim TH et al. Analysis of treatment outcomes according to the cycles of adjuvant chemotherapy in gastric cancer: A retrospective nationwide cohort study. BMC Cancer. 2022;22(1):948 (Sep 3). Doi: 10.1186/s12885-022-10006-7

Key clinical point: A reduction in the treatment cycle number of adjuvant chemotherapy with S-1 (Tegafur+ 5-chloro-2-4-dihydroxypyridine+oxonic acid) or capecitabine/oxaliplatin (CAPOX) in gastric cancer results in poorer survival outcomes.

Major finding: The 5-year overall survival rates in patients who received S-1 gradually increased from 48.4% to 55.4%, 64.1%, 71.1%, and 77.9% with an increase in cycle number from ≤5 to ≥8 cycles (P < .0001), with the same trend being observed with CAPOX (≤4 to ≥8 cycles: 43.5%, 45.3%, 47.1%, 55.3%, and 67.2%; P < .0001).

Study details: This retrospective study included 20,552 patients with gastric cancer who received 12-month S-1 (n = 13,614) or 6-month CAPOX (n = 6938) adjuvant chemotherapy.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kim TH et al. Analysis of treatment outcomes according to the cycles of adjuvant chemotherapy in gastric cancer: A retrospective nationwide cohort study. BMC Cancer. 2022;22(1):948 (Sep 3). Doi: 10.1186/s12885-022-10006-7

Key clinical point: Tumor mutational burden (TMB) status is associated with the clinical outcomes of the first-line pembrolizumab-based therapy in patients with advanced gastric cancer.

Major finding: TMB was significantly associated with the objective response rate, progression-free survival, and overall survival in the pembrolizumab monotherapy and pembrolizumab-chemotherapy treatment groups (1-sided P < .05) but not in the chemotherapy group (2-sided P > .05).

Study details: This prespecified exploratory analysis included 306 patients with advanced gastric cancer and evaluable TMB data who received pembrolizumab alone, pembrolizumab+chemotherapy, or chemotherapy alone in the phase 3 KEYNOTE-062 trial (n = 763).

Disclosures: This study was sponsored by Merck Sharp & Dohme (MSD) LLC, a subsidiary of Merck & Co., Inc., NJ Some authors reported receiving grants or personal fees from various sources, including MSD and Merck. Two authors declared being employees of MSD or Merck.

Source: Lee KW et al. Association of tumor mutational burden with efficacy of pembrolizumab±chemotherapy as first-line therapy for gastric cancer in the phase III KEYNOTE-062 study. Clin Cancer Res. 2022;28(16):3489-3498 (Aug 15). Doi: 10.1158/1078-0432.CCR-22-0121

Key clinical point: Tumor mutational burden (TMB) status is associated with the clinical outcomes of the first-line pembrolizumab-based therapy in patients with advanced gastric cancer.

Major finding: TMB was significantly associated with the objective response rate, progression-free survival, and overall survival in the pembrolizumab monotherapy and pembrolizumab-chemotherapy treatment groups (1-sided P < .05) but not in the chemotherapy group (2-sided P > .05).

Study details: This prespecified exploratory analysis included 306 patients with advanced gastric cancer and evaluable TMB data who received pembrolizumab alone, pembrolizumab+chemotherapy, or chemotherapy alone in the phase 3 KEYNOTE-062 trial (n = 763).

Disclosures: This study was sponsored by Merck Sharp & Dohme (MSD) LLC, a subsidiary of Merck & Co., Inc., NJ Some authors reported receiving grants or personal fees from various sources, including MSD and Merck. Two authors declared being employees of MSD or Merck.

Source: Lee KW et al. Association of tumor mutational burden with efficacy of pembrolizumab±chemotherapy as first-line therapy for gastric cancer in the phase III KEYNOTE-062 study. Clin Cancer Res. 2022;28(16):3489-3498 (Aug 15). Doi: 10.1158/1078-0432.CCR-22-0121

Key clinical point: Tumor mutational burden (TMB) status is associated with the clinical outcomes of the first-line pembrolizumab-based therapy in patients with advanced gastric cancer.

Major finding: TMB was significantly associated with the objective response rate, progression-free survival, and overall survival in the pembrolizumab monotherapy and pembrolizumab-chemotherapy treatment groups (1-sided P < .05) but not in the chemotherapy group (2-sided P > .05).

Study details: This prespecified exploratory analysis included 306 patients with advanced gastric cancer and evaluable TMB data who received pembrolizumab alone, pembrolizumab+chemotherapy, or chemotherapy alone in the phase 3 KEYNOTE-062 trial (n = 763).

Disclosures: This study was sponsored by Merck Sharp & Dohme (MSD) LLC, a subsidiary of Merck & Co., Inc., NJ Some authors reported receiving grants or personal fees from various sources, including MSD and Merck. Two authors declared being employees of MSD or Merck.

Source: Lee KW et al. Association of tumor mutational burden with efficacy of pembrolizumab±chemotherapy as first-line therapy for gastric cancer in the phase III KEYNOTE-062 study. Clin Cancer Res. 2022;28(16):3489-3498 (Aug 15). Doi: 10.1158/1078-0432.CCR-22-0121

Key clinical point: Intensive index endoscopy in individuals with high risk for gastric cancer does not reduce the detection rate of new gastric cancers after 1 year.

Major finding: The rate of early gastric cancer detection by index endoscopy was similar to that of new gastric cancer detection by surveillance endoscopy within 15 months after index endoscopy (3.0% vs 2.6%).

Study details: This case-control secondary analysis of the data of 4523 individuals with high risk for gastric cancer from a randomized clinical trial who received index endoscopy comprising two examinations of the stomach with white light and narrow-band imaging.

Disclosures: This study was sponsored by Kyoto University, Japan, and Olympus Medical Systems. Some authors reported receiving grants or personal fees from various sources, including Olympus Medical Systems.

Source: Yamamoto Y et al. Assessment of outcomes from 1-year surveillance after detection of early gastric cancer among patients at high risk in Japan. JAMA Netw Open. 2022;5(8):e2227667 (Aug 19). Doi: 10.1001/jamanetworkopen.2022.27667

Key clinical point: Intensive index endoscopy in individuals with high risk for gastric cancer does not reduce the detection rate of new gastric cancers after 1 year.

Major finding: The rate of early gastric cancer detection by index endoscopy was similar to that of new gastric cancer detection by surveillance endoscopy within 15 months after index endoscopy (3.0% vs 2.6%).

Study details: This case-control secondary analysis of the data of 4523 individuals with high risk for gastric cancer from a randomized clinical trial who received index endoscopy comprising two examinations of the stomach with white light and narrow-band imaging.

Disclosures: This study was sponsored by Kyoto University, Japan, and Olympus Medical Systems. Some authors reported receiving grants or personal fees from various sources, including Olympus Medical Systems.

Source: Yamamoto Y et al. Assessment of outcomes from 1-year surveillance after detection of early gastric cancer among patients at high risk in Japan. JAMA Netw Open. 2022;5(8):e2227667 (Aug 19). Doi: 10.1001/jamanetworkopen.2022.27667

Key clinical point: Intensive index endoscopy in individuals with high risk for gastric cancer does not reduce the detection rate of new gastric cancers after 1 year.

Major finding: The rate of early gastric cancer detection by index endoscopy was similar to that of new gastric cancer detection by surveillance endoscopy within 15 months after index endoscopy (3.0% vs 2.6%).

Study details: This case-control secondary analysis of the data of 4523 individuals with high risk for gastric cancer from a randomized clinical trial who received index endoscopy comprising two examinations of the stomach with white light and narrow-band imaging.

Disclosures: This study was sponsored by Kyoto University, Japan, and Olympus Medical Systems. Some authors reported receiving grants or personal fees from various sources, including Olympus Medical Systems.

Source: Yamamoto Y et al. Assessment of outcomes from 1-year surveillance after detection of early gastric cancer among patients at high risk in Japan. JAMA Netw Open. 2022;5(8):e2227667 (Aug 19). Doi: 10.1001/jamanetworkopen.2022.27667

Key clinical point: Intraperitoneal paclitaxel (IP-PTX) combined with capecitabine/oxaliplatin (XELOX) in patients with gastric cancer peritoneal metastases (GCPM) is safe and improves survival outcomes compared with systemic chemotherapy (SC) alone.

Major finding: After a median follow-up of 12.1 months, patients receiving IP-PTX+XELOX vs SC had a significantly longer median overall survival (14.6 vs 10.6 months; hazard ratio [HR] 0.44; P = .002) and progression-free survival (9.5 vs 4.4 months; HR 0.39; P < .001). The Common Terminology Criteria for Adverse Event grade 5 complication rate with IP-PTX+XELOX was 5%.

Study details: This prospective phase 2 study analyzed IP-PTX+XELOX treatment outcomes in 44 patients with GCPM and compared them with SC (fluoropyrimidine/platinum doublet) treatment outcomes in a matched retrospective cohort of 39 patients with GCPM.

Disclosures: This study was sponsored by the National Medical Research Council, Singapore. S Raghav declared serving as an advisory board member of and receiving speaker honoraria and research funding from various sources.

Source: Chia DKA et al. Outcomes of a phase II study of intraperitoneal paclitaxel plus systemic capecitabine and oxaliplatin (XELOX) for gastric cancer with peritoneal metastases. Ann Surg Oncol. 2022 (Sep 7). Doi: 10.1245/s10434-022-11998-z

Key clinical point: Intraperitoneal paclitaxel (IP-PTX) combined with capecitabine/oxaliplatin (XELOX) in patients with gastric cancer peritoneal metastases (GCPM) is safe and improves survival outcomes compared with systemic chemotherapy (SC) alone.

Major finding: After a median follow-up of 12.1 months, patients receiving IP-PTX+XELOX vs SC had a significantly longer median overall survival (14.6 vs 10.6 months; hazard ratio [HR] 0.44; P = .002) and progression-free survival (9.5 vs 4.4 months; HR 0.39; P < .001). The Common Terminology Criteria for Adverse Event grade 5 complication rate with IP-PTX+XELOX was 5%.

Study details: This prospective phase 2 study analyzed IP-PTX+XELOX treatment outcomes in 44 patients with GCPM and compared them with SC (fluoropyrimidine/platinum doublet) treatment outcomes in a matched retrospective cohort of 39 patients with GCPM.

Disclosures: This study was sponsored by the National Medical Research Council, Singapore. S Raghav declared serving as an advisory board member of and receiving speaker honoraria and research funding from various sources.

Source: Chia DKA et al. Outcomes of a phase II study of intraperitoneal paclitaxel plus systemic capecitabine and oxaliplatin (XELOX) for gastric cancer with peritoneal metastases. Ann Surg Oncol. 2022 (Sep 7). Doi: 10.1245/s10434-022-11998-z

Key clinical point: Intraperitoneal paclitaxel (IP-PTX) combined with capecitabine/oxaliplatin (XELOX) in patients with gastric cancer peritoneal metastases (GCPM) is safe and improves survival outcomes compared with systemic chemotherapy (SC) alone.

Major finding: After a median follow-up of 12.1 months, patients receiving IP-PTX+XELOX vs SC had a significantly longer median overall survival (14.6 vs 10.6 months; hazard ratio [HR] 0.44; P = .002) and progression-free survival (9.5 vs 4.4 months; HR 0.39; P < .001). The Common Terminology Criteria for Adverse Event grade 5 complication rate with IP-PTX+XELOX was 5%.

Study details: This prospective phase 2 study analyzed IP-PTX+XELOX treatment outcomes in 44 patients with GCPM and compared them with SC (fluoropyrimidine/platinum doublet) treatment outcomes in a matched retrospective cohort of 39 patients with GCPM.

Disclosures: This study was sponsored by the National Medical Research Council, Singapore. S Raghav declared serving as an advisory board member of and receiving speaker honoraria and research funding from various sources.

Source: Chia DKA et al. Outcomes of a phase II study of intraperitoneal paclitaxel plus systemic capecitabine and oxaliplatin (XELOX) for gastric cancer with peritoneal metastases. Ann Surg Oncol. 2022 (Sep 7). Doi: 10.1245/s10434-022-11998-z