Rishabh Jain, Medical Oncologist at AIIMS, shared a post on LinkedIn:
“Resectable Gastric Cancer | GI26
CRITICS-II answers a key question
What is the best preoperative strategy when adjuvant therapy is omitted?
Trial design:
Three fully neoadjuvant approaches compared
- Chemotherapy alone
- Chemotherapy → Chemoradiotherapy
- Chemoradiotherapy alone
Primary endpoint:
1-year event-free survival
Activity threshold ≥75%
Key results:
- CT → CRT: 1-yr EFS 84% | 1-yr OS 89% | pCR 20%
- CRT alone: 1-yr EFS 78% | better compliance | lower toxicity
- CT alone: 1-yr EFS 68% | lowest survival | higher toxicity
Clinical interpretation:
- Chemotherapy alone fails efficacy threshold
- Total neoadjuvant therapy gives the best oncologic signal
- CRT alone offers a toxicity-compliant alternative
- CT → CRT emerges as the preferred backbone for phase III testing and organ-sparing strategies
Take-home message:
In resectable gastric cancer, treatment intensification before surgery matters.
Pure chemo upfront is no longer convincing.”
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