1:Doublet chemotherapy, triplet chemotherapy, or doublet chemotherapy combined with radiotherapy as neoadjuvant treatment for locally advanced oesophageal cancer (JCOG1109 NExT): a randomised, controlled, open-label, phase 3 trial.
Science of the Month - September 2024
Lancet.
Kato K, Machida R, Ito Y, Daiko H, Ozawa S, Ogata T, Hara H, Kojima T, Abe T, Bamba T, Watanabe M, Kawakubo H, Shibuya Y, Tsubosa Y, Takegawa N, Kajiwara T, Baba H, Ueno M, Takeuchi H, Nakamura K, Kitagawa Y.
The standard treatment in Japan for resectable esophageal squamous cell carcinoma was esophagectomy after neoadjuvant CF therapy with fluorouracil and cisplatin, but further improvement in treatment outcomes was needed. JCOG1109 is a randomized, controlled, phase 3 trial aimed at verifying the survival-prolonging effect of DCF therapy, a triplet chemotherapy regimen that adds docetaxel to CF therapy. Furthermore, considering that neoadjuvant chemoradiotherapy was widely practiced in Europe and the United States, unlike in Japan, the efficacy of neoadjuvant chemoradiotherapy, which adds radiotherapy to CF therapy, was also evaluated. Two hundred patients were enrolled in each group. The results of the primary analysis showed the superiority of neoadjuvant DCF therapy over CF therapy in terms of overall survival, establishing it as the new standard of care. On the other hand, no additional benefit of neoadjuvant chemoradiotherapy was demonstrated, suggesting that when surgery with highly precise lymph node dissection, as performed in Japan, is the premise, the addition of radiotherapy may not be necessary. Primarily in East Asia, the efficacy of neoadjuvant DCF therapy is already beginning to be recognized. It is expected that the effectiveness of systemic tumor control with neoadjuvant triplet chemotherapy and the importance of local control through excellent surgery, as demonstrated through this trial, will bring about a transformation in the global standard of care for esophageal cancer.
(Yuko Kitagawa (65th) and Hirofumi Kawakubo (73rd), Department of Surgery (General and Gastroenterological))
2: The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groups in the Forthcoming (Ninth) Edition of the TNM Classification for Lung Cancer.
Journal of Thoracic Oncology
.
Rami-Porta R, Nishimura KK, Giroux DJ, Detterbeck F, Cardillo G, Edwards JG, Fong KM, Giuliani M, Huang JM, Kernstine KH, Sr., Marom EM, Nicholson AG, Van Schil PE, Travis WD, Tsao MS, Watanabe SI, Rusch VW, Asamura H.
3：The International Association for the Study of Lung Cancer (IASLC) Staging Project for Lung Cancer: Recommendation to Introduce Spread Through Air Spaces as a Histologic Descriptor in the Ninth Edition of the TNM Classification of Lung Cancer. Analysis of 4061 Pathologic Stage I NSCLC.
Journal of Thoracic Oncology.
Travis WD, Eisele M, Nishimura KK, Aly RG, Bertoglio P, Chou TY, Detterbeck FC, Donnington J, Fang WT, Joubert P, Kernstine K, Kim YT, Lievens Y, Liu H, Lyons G, Mino-Kenudson M, Nicholson AG, Papotti M, Rami-Porta R, Rusch V, Sakai S, Ugalde P, Van Schil P, Yang CFJ, Cilento VJ, Yotsukura M, Asamura H.
4:The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for Revision of the Classification of Residual Tumor After Resection for the Forthcoming (Ninth) Edition of the TNM Classification of Lung Cancer.
Journal of Thoracic Oncology .
Detterbeck FC, Ostrowski M, Hoffmann H, Rami-Porta R, Osarogiagbon RU, Donnington J, Infante M, Marino M, Marom EM, Nakajima J, Nicholson AG, van Schil P, Travis WD, Tsao MS, Edwards JG, Asamura H.
In April, I wrote a commentary on three papers regarding the TNM classification for thymic tumors. These three new papers are proposed revisions to the staging classification for lung cancer, submitted to the official journal, the *Journal of Thoracic Oncology* (JTO), by the International Association for the Study of Lung Cancer (IASLC) Staging and Prognostic Factors Committee, which was responsible for drafting them. Although there is some overlap with my previous commentary, it is best to understand this revision in the same context as the one for thymic tumors. The TNM classification for malignant tumors of all organs has been revised globally every seven years by the UICC and AJCC, and 2024 is the year the 9th edition comes into effect. Lung cancer, thymic tumors, pleural tumors, and esophageal cancer are special cases, for which a scheme is in place where the responsible academic society, the IASLC, drafts the proposed revisions. A total of 28 papers will be published within this fiscal year. These three papers form the core of this effort. I served as the chair of this committee for seven years and successfully completed the drafting of the proposed revisions; these papers are the fruit of those activities. Work has already begun on the 10th edition, which will come into effect in 2031, for each organ.
(Hisao Asamura (62nd), Corporate Advisor and Project Professor, Tokyo Dental College Ichikawa General Hospital)