Perioperative immunotherapy in gastric cancer in the spotlight

Table 1 Adjuvant therapy: Summary of key randomized trials evaluating adjuvant therapy strategies in gastric and gastroesophageal junction adenocarcinoma

Trial name	Disease subtype	Strategy	DFS	OS
INT-0116 (SWOG 9008) (2001/2012)	G/GEJ adenocarcinoma	Adjuvant CRT vs observation	10-year median DFS: 27 months (CRT) vs 19 months	10-year median OS: 35 months (CRT) vs 27 months
			HR: 1.51 (1.25-1.83)	HR: 1.32 (1.10-1.60)
			P < 0.001	P = 0.0046
CLASSIC trial (2012/2014)	Gastric adenocarcinoma	Adjuvant CT (CAPOX) vs observation	5-year DFS: 68% (CAPOX) vs 53%	5-year OS: 78% (CAPOX) vs 69%
			HR: 0.58 (0.47-0.72)	HR: 0.66 (0.51-0.85)
			P < 0.0001	P = 0.0015
ARTIST trial (2012/2015)	Mostly gastric adenocarcinoma (few GEJ)	Adjuvant CT vs adjuvant CRT	3-year DFS: 78.2% (CRT) vs 74.2% (CT)	5-year OS: 75% (CRT) vs 73% (CT)
			P = 0.0862
			Subgrup with node metastasis 3-year DFS
			77.5% (CRT) vs 72.3% (CT)
			HR: 0.68 (0.47-0.99)	HR: 1.13 (0.77-1.64)
			P = 0.0471	P = 0.52
ARTIST 2 trial (2021)	Gastric adenocarcinoma only and node positive	Adjuvant	3-year DFS: 64.8% (S-1), 74.3% (SOX), 72.8% (SOXRT)	No OS data so far (secondary endpoint)
		S-1	HR S-1 vs SOX: 0.692, P = 0.042
			HR S-1 vs SOXRT: 0.724, P = 0.074
		SOX vs SOXRT	No difference was found between SOX and SOXRT (HR 0.971, P = 0.879)

DFS: Disease-free survival; OS: Overall survival; G/GEJ: Gastric and gastroesophageal junction; CRT: Chemoradiotherapy; HR: Hazard ratio; CT: Chemotherapy; CAPOX: Capecitabine, oxaliplatin, docetaxel; S-1: Oral 5-fluorouracil; SOX: S-1 and oxaliplatin; SOXRT: S-1 and oxaliplatin plus chemoradiotherapy.