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The Clinical Efficacy of Drug Sensitive Neoadjuvant Chemotherapy Based on Organoid Versus Traditional Neoadjuvant Chemotherapy in Advanced Gastric Cancer

Conditions
Advanced Gastric Carcinoma
Interventions
Drug: PDO group
Drug: Traditional group
Registration Number
NCT05351398
Lead Sponsor
Shanghai Minimally Invasive Surgery Center
Brief Summary

Neoadjuvant chemotherapy has become the mainstream recommended treatment for advanced gastric cancer. However, due to the heterogeneity of gastric cancer, part of some patients fail to benefit from the treatment. This project aims to compare the clinical efficacy of individualized neoadjuvant therapy based on patient-derived organoid drug sensitivity assay and traditional regimen, exploring the advantages and disadvantages of these two treatments. And access the safety and clinical value of the personalized neoadjuvant therapy based on patient-derived organoid drug sensitivity assay in advanced gastric cancer.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
54
Inclusion Criteria
  • Age between 18 and 80 years
  • A biopsy proven histological diagnosis of gastric adenocarcinoma or high-grade intraepithelial neoplasia
  • Tumor located at stomach
  • Chest/abdomen/pelvis CT scans or gastric cancer staging CT scan evaluate the clinical stage of tumor as stage III:

A. preoperative staging cT3-4N1-2 B. excluding distant organ metastasis (M0)

  • Eastern Cooperative Oncology Group (ECOG) score ≤1
  • Willing to participate and informed consent signed
Exclusion Criteria
  • Pregnant or lactating women
  • Synchronous or heterochronic malignant carcinomas
  • History of malignant carcinomas
  • Clinical evidence of metastasis
  • Abnormal heart, lung, liver, kidney, hematopoietic function and bone marrow reserve function, unable to tolerate surgical treatment and chemotherapy
  • Mental illness or other serious cardiovascular disease
  • Emergency procedure

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
PDO groupPDO groupPatients with stage III gastric cancer who need neoadjuvant chemotherapy before radical surgery are recruited. And they are treated with individualized neoadjuvant therapy under the guidance of a patient-derived organoid (PDO)-based drug sensitivity assay.
Traditional groupPDO groupPatients with stage III gastric cancer who need neoadjuvant chemotherapy before radical surgery are recruited. In this group, patients are treated with the SOX regimen.
Traditional groupTraditional groupPatients with stage III gastric cancer who need neoadjuvant chemotherapy before radical surgery are recruited. In this group, patients are treated with the SOX regimen.
PDO groupTraditional groupPatients with stage III gastric cancer who need neoadjuvant chemotherapy before radical surgery are recruited. And they are treated with individualized neoadjuvant therapy under the guidance of a patient-derived organoid (PDO)-based drug sensitivity assay.
Primary Outcome Measures
NameTimeMethod
Objective Response Ratean average of 1 year

proportion of patients whose tumor volume reduced to a predetermined value and maintain the minimum time limit.

Secondary Outcome Measures
NameTimeMethod
postoperative complicationan average of 1 year

postoperative complication

postoperative tumor regression gradingan average of 1 year

grade the pathological response of tumor after neoadjuvant treatment, which is usually classified according to the proportion of fibrosis and residual tumor in tumor tissues.

3-year recurrence ratean average of 3 year

proportion of patients who relapse within 3 years after operation

chemotherapy tolerance and adverse reaction ratean average of 1 year
R0 resection ratean average of 1 year

Trial Locations

Locations (1)

Shanghai Ruijin Hospttal

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Shanghai, Sahnghai, China

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