NL
In patients with gastric cancer receiving perioperative chemotherapy, the side effects during the first course of treatment appear to show significant differences. A hierarchical cluster analysis identified four patterns of early toxicity. These patterns predicted survival: patients with mainly neutropenia had the best prognosis (median 58 months), while severe gastrointestinal complaints were associated with the worst survival (median 22 months). This indicates that early side effects can provide valuable information about the expected treatment outcome.
This study investigated whether early side effects during perioperative chemotherapy for gastric cancer can predict the further treatment outcome. To this end, a hierarchical cluster analysis was performed on data from 788 patients from the randomized CRITICS trial. In this trial, perioperative chemotherapy was compared with preoperative chemotherapy followed by postoperative chemoradiotherapy.
Based on side effects during the first course of chemotherapy, four distinct groups were identified: a mild cluster, a cluster with mainly neutropenia, a polytoxicity cluster, and a cluster with mainly gastrointestinal complaints. These groups differed greatly in terms of survival. Patients in the neutropenia cluster had the best prognosis (median 58 months), while patients with predominantly gastrointestinal toxicity had significantly poorer survival (median 22 months).
The results show that early toxicity not only reflects side effects, but can also provide valuable information about how the body responds to treatment. This may offer opportunities for earlier risk stratification and more personalized adjustments to the treatment pathway. However, further confirmation in other patient groups is needed, including patients treated according to the current FLOT regimen.
van Amelsfoort RM, González P, Simões R, Jansen EPM, Cats A, van Grieken NCT, Sikorska K, Klein Kranenbarg EM, Putter H, van de Velde CJH, van Sandick JW, Verheij M, Walraven I; CRITICS investigators. A novel approach to assess the prognostic value of toxicity profiles in gastric cancer patients undergoing preoperative treatment. Eur J Cancer. 2025 Oct 1;228:115672.