Adding oxaliplatin to adjuvant S-1 lifted five-year survival in gastric cancer

The edition in brief

The CAPITAL phase 3 trial randomised 724 patients with stage II–III gastric or gastro-oesophageal junction adenocarcinoma after D2 gastrectomy to adjuvant oxaliplatin plus S-1 or S-1 alone. At a median 74 months, five-year overall survival was 70.9% with the doublet against 62.9% with S-1 (hazard ratio 0.74, 95% CI 0.58–0.95), and five-year disease-free survival 66.2% against 55.6%. Grade 3–4 treatment-related adverse events roughly doubled, 25% against 13%, driven by neutropenia. An American Gastroenterological Association clinical practice update sets out fifteen best-practice statements on ampullary neoplasms: side-viewing duodenoscope for assessment, at least six biopsies because 20–40% harbour malignancy, endoscopic ultrasound for staging, and a surveillance schedule running to five years after papillectomy. A meta-analysis of proportions provides benchmark figures for T-cell prolymphocytic leukaemia — pooled overall response to alemtuzumab-based therapy 81.9%, around 85% frontline against 51% in relapsed or refractory disease, and long-term survival after allogeneic transplant 30.3% across 363 registry patients. An updated comparison of robotic and laparoscopic colorectal surgery found higher event rates with robotic surgery on every outcome, and the authors state plainly that their own results are unsuitable for clinical inference because only 8–10% of eligible studies had extractable data. A pearl covers recording performance status. The edition closes with the SYMPRO-Lung long-term analysis, in which weekly online symptom monitoring for a year was associated with median overall survival of 26 months against 21, hazard ratio 0.80 (0.63–1.00), in a stepped-wedge cluster-randomised trial across 14 Dutch centres.