High prevalence of severe hypovitaminosis D in patients with advanced gastric cancer treated with first-line chemotherapy with or without anti-EGFR-directed monoclonal antibody (EXPAND trial) showing no prognostic impact

The efficacy and safety of neoadjuvant nimotuzumab for gastric cancer: A meta-analysis of randomized controlled studies

INTRODUCTION

The efficacy of neoadjuvant nimotuzumab for gastric cancer remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of neoadjuvant nimotuzumab plus chemotherapy vs chemotherapy for gastric cancer.

METHODS

We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through May 2019, and included randomized controlled trials assessing the efficacy of neoadjuvant nimotuzumab plus chemotherapy vs chemotherapy for gastric cancer. This meta-analysis was performed using the random-effect model.

RESULTS

Four randomized controlled trials were included in the meta-analysis. There were 128 patients included in intervention group and 131 patients included in control group. Overall, compared with chemotherapy for gastric cancer, neoadjuvant nimotuzumab plus chemotherapy showed no substantial influence on response rate (risk ratio [RR] = 1.22; 95% CI = 0.78-1.89; P = .38), disease control rate (RR = 2.22; 95% confidence interval [CI] = 0.32-15.40; P = .42), rash (RR = 1.26; 95% CI = 0.96-1.66; P = .10), neutropenia (RR = 1.26; 95% CI = 0.96-1.66; P = .10), anemia (RR = 1.08; 95% CI = 0.62-1.89; P = .78), or nausea (RR = 1.19; 95% CI = 0.96-1.48; P = .12), but might improve the incidence of vomiting (RR = 1.60; 95% CI = 1.03-2.50; P = .04).

CONCLUSIONS

Neoadjuvant nimotuzumab might provide no additional benefits to the treatment of gastric cancer.

Association between serum 25-hydroxy vitamin D level and gastric adenocarcinoma - a cross sectional study

Introduction

Vitamin D is found to have anti-cancer properties. Although the preventive role of vitamin D in cancer is proven, its role in gastric cancer is equivocal.

Aim

To evaluate vitamin D deficiency in patients with gastric adenocarcinoma and its relationship with the disease characteristics.

Material and methods

This single-centre, prospective, cross sectional study was carried out from February 2017 to December 2018. Serum 25-hydroxy vitamin D levels of 94 patients with gastric adenocarcinoma and 94 age- and sex-matched healthy controls were estimated. Among cases, vitamin D levels and disease characteristics such as TNM stage, tumour grade, clinical stage and patient demographics were analysed.

Results

The vitamin D levels among cases (13.83 ±5.97 ng/ml) were significantly lower (p < 0.0001) than the control group (29.15 ±4.13 ng/ml). Vitamin D deficiency was found in 88% of cases and in 3% of controls. Among cases, age, T stage and clinical stage had a significant inverse relationship with vitamin D levels. Cases with distant metastasis and cases with pain had significantly lower levels of vitamin D compared to the cases without distant metastasis and without pain respectively. Other study parameters did not have a significant relationship with vitamin D.

Conclusions

Vitamin D deficiency is associated with occurrence of gastric adenocarcinoma and correlates with the disease severity. However, to assign a causal relationship and to study the beneficial effect of vitamin D in gastric cancer, further research is needed.