Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2016
Effect of Pathologic Tumor Response and Nodal Status on Survival in the Medical Research Council Adjuvant Gastric Infusional Chemotherapy Trial.
Registry-linked trialAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03515941 (A Pilot Study in Gastric Cancer of Assignment to Postoperative Chemoradiation or Chemotherapy Based Upon Surgical Lymph Node Assessment After Preoperative Chemotherapy, With Gene Assay as Correlate of Biologic Response), which is not on this map. Cited by 156 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
156citing papers in PubMed, 1 pooled it
–field-weighted citation impact
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
NCT03515941 early_phase1terminatednot on this mapstarted 2018, after this paper: background citation
A Pilot Study in Gastric Cancer of Assignment to Postoperative Chemoradiation or Chemotherapy Based Upon Surgical Lymph Node Assessment After Preoperative Chemotherapy, With Gene Assay as Correlate of Biologic Response
Who cites it
156 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association of ctDNA detection and recurrence assessment in patients with neoadjuvant treatment.Cancer medicine · 2023Pooled it
- Trial
- Trifluridine/Tipiracil and Oxaliplatin as Induction Chemotherapy in Resectable Esophageal and Gastroesophageal Junction Adenocarcinoma: A Phase II Study.Cancer medicine · 2025Trial
- NESC Multicenter Phase II Trial in the Preoperative Treatment of Gastric Adenocarcinoma with Chemotherapy (Docetaxel-Cisplatin-5FU+Lenograstim) Followed by Chemoradiation Based 5FU and Oxaliplatin and Surgery.Cancer research and treatment · 2024Trial
- Nomogram for predicting pathological response to neoadjuvant treatment in patients with locally advanced gastric cancer: Data from a phase III clinical trial.Cancer medicine · 2024Trial
- Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2022Trial
- Primary Tumor Location Is a Predictor of Poor Prognosis in Patients with Locally Advanced Esophagogastric Cancer Treated with Perioperative Chemotherapy.Journal of gastrointestinal cancer · 2020Trial
- A seven-Gene Signature assay improves prognostic risk stratification of perioperative chemotherapy treated gastroesophageal cancer patients from the MAGIC trial.Annals of oncology : official journal of the European Society for Medical Oncology · 2018Trial
- Pharmacogenetic Analysis of the UK MRC (Medical Research Council) MAGIC Trial: Association of Polymorphisms with Toxicity and Survival in Patients Treated with Perioperative Epirubicin, Cisplatin, and 5-fluorouracil (ECF) Chemotherapy.Clinical cancer research : an official journal of the American Association for Cancer Research · 2017Trial
- Multimodality treatment for esophageal adenocarcinoma: multi-center propensity-score matched study.Annals of oncology : official journal of the European Society for Medical Oncology · 2017Trial
- Peri-operative chemotherapy with or without bevacizumab in operable oesophagogastric adenocarcinoma (UK Medical Research Council ST03): primary analysis results of a multicentre, open-label, randomised phase 2-3 trial.The Lancet. Oncology · 2017Trial
- Early relapses after adjuvant chemotherapy suggests primary chemoresistance in diffuse gastric cancer.PloS one · 2017Trial
- Re-evaluating the role of adjuvant chemotherapy after neoadjuvant chemotherapy in resected gastric cancer.The oncologist · 2026Article
- Integrated Prognostic Stratification After Perioperative FLOT in Gastric and Gastroesophageal Junction Adenocarcinoma: A Multicenter Real-World Study.Journal of clinical medicine · 2026Article
- Small Extracellular Vesicle-TLN1 Modulates Gastric Cancer Cells and Remodels Lymphatic Endothelial Cells Through AKT Activation to Potentiate Lymphatic Metastasis.Cell biology international · 2026Article
- Prognostic and Predictive Significance of Body Mass Index in Locally Advanced Gastric Cancer Receiving Neoadjuvant Chemotherapy: A Retrospective Multicenter Cohort Study.Journal of clinical medicine · 2026Article
- Impact of Pharmacogenetic Markers on the Efficacy of Neoadjuvant FLOT Chemotherapy in Patients with Gastric and Gastroesophageal Junction Adenocarcinoma.International journal of molecular sciences · 2026Article
- Association between effectiveness of treatment with curative intent and outcomes of first-line systemic therapy in metachronous metastatic gastroesophageal adenocarcinoma.British journal of cancer · 2026Article
- Discordance in tumour response assessment for gastric cancer after neoadjuvant chemotherapy using different methods.Abdominal radiology (New York) · 2026Article
- Article
96 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors.
Elizabeth C SmythElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Matteo FassanElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
David CunninghamElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
William H AllumElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Alicia F C OkinesElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Andrea LampisElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Jens C HahneElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Massimo RuggeElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Clare PeckittElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Matthew NankivellElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Ruth LangleyElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Michele GhidiniElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Chiara BraconiElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Andrew WotherspoonElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Heike I GrabschElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands.
Nicola ValeriElizabeth C. Smyth, David Cunningham, William H. Allum, Alicia F.C. Okines, Clare Peckitt, Chiara Braconi, Andrew Wotherspoon, and Nicola Valeri, Royal Marsden Hospital; Andrea Lampis, Jens C. Hahne, Michele Ghidini, Chiara Braconi, and Nicola Valeri, The Institute of Cancer Research, London and Sutton; Matthew Nankivell and Ruth Langley, Medical Research Council Clinical Trials Unit at UCL, London; Heike I. Grabsch, University of Leeds, Leeds, United Kingdom; Matteo Fassan and Massimo Rugge, University of Padua, Padua, Italy; and Heike I. Grabsch, Maastricht University Medical Center, Maastricht, the Netherlands. nicola.valeri@icr.ac.uk.
Funding
Cancer Research UK 18052Cancer Research UK CEAA18052Medical Research Council MC_U122861327Medical Research Council MC_UU_12023/28
Abstract
purposeThe Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial established perioperative epirubicin, cisplatin, and fluorouracil chemotherapy as a standard of care for patients with resectable esophagogastric cancer. However, identification of patients at risk for relapse remains challenging. We evaluated whether pathologic response and lymph node status after neoadjuvant chemotherapy are prognostic in patients treated in the MAGIC trial. MATERIALS AND
methodsPathologic regression was assessed in resection specimens by two independent pathologists using the Mandard tumor regression grading system (TRG). Differences in overall survival (OS) according to TRG were assessed using the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate analyses using the Cox proportional hazards method established the relationships among TRG, clinical-pathologic variables, and OS.
resultsThree hundred thirty resection specimens were analyzed. In chemotherapy-treated patients with a TRG of 1 or 2, median OS was not reached, whereas for patients with a TRG of 3, 4, or 5, median OS was 20.47 months. On univariate analysis, high TRG and lymph node metastases were negatively related to survival (Mandard TRG 3, 4, or 5: hazard ratio [HR], 1.94; 95% CI, 1.11 to 3.39; P = .0209; lymph node metastases: HR, 3.63; 95% CI, 1.88 to 7.0; P < .001). On multivariate analysis, only lymph node status was independently predictive of OS (HR, 3.36; 95% CI, 1.70 to 6.63; P < .001).
conclusionLymph node metastases and not pathologic response to chemotherapy was the only independent predictor of survival after chemotherapy plus resection in the MAGIC trial. Prospective evaluation of whether omitting postoperative chemotherapy and/or switching to a noncross-resistant regimen in patients with lymph node-positive disease whose tumor did not respond to preoperative epirubicin, cisplatin, and fluorouracil may be appropriate.
Indexed as
Lymph Node ExcisionAdenocarcinomaAgedAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantCisplatinClass I Phosphatidylinositol 3-KinasesEpirubicinErb-b2 Receptor Tyrosine KinasesEsophageal NeoplasmsFemaleFluorouracilHumansLymphatic MetastasisLymph NodesMaleBRAF protein, humanCisplatinClass I Phosphatidylinositol 3-KinasesEpirubicinERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesFluorouracilKRAS protein, humanPhosphatidylinositol 3-KinasesPIK3CA protein, humanProto-Oncogene Proteins B-rafProto-Oncogene Proteins p21(ras)PTEN PhosphohydrolasePTEN protein, humanTumor Suppressor Protein p53
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Registered trials
NCT03515941ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.