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PubMed · 42600610

Adjuvant oxaliplatin with S-1 (SOX) versus S-1 for stage II-III gastric cancer (CAPITAL): A randomized, open-label, phase 3 trial.

Run-Cong Nie·Shi Chen·Jin Wan·Xiao-Wei Sun·Wei-Qin Hong·Hong-Bo Wei·Wei Wang·Wen-Bin Zhang·Yan Zhao·Wei-Bin Zhang·Jing-Song Chen·Zu-Guang Wu·Cong Mai·Chun-Zai Feng·Shu-Qiang Yuan·Hai-Bo Qiu·Yao Liang·Yuan-Xiang Guan·Yong-Ming Chen·Wen-Wu Liu·Chao Ding·Jun-Sheng Peng·Ying-Bo Chen·Zhi-Wei Zhou·Yuan-Fang Li
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Abstract

BACKGROUND: Adjuvant chemotherapy following D2 gastrectomy constitutes the standard-of-care for resectable gastric or gastroesophageal junction (GEJ) carcinoma. The CAPITAL trial is a multicenter, randomized, phase 3 study, aiming to assess the efficacy and safety of adjuvant oxaliplatin plus S-1 (SOX) versus S-1 alone. METHODS: Patients with histologically confirmed pathological stage II-III gastric or GEJ adenocarcinoma after gastrectomy with D2 lymphadenectomy were randomly assigned (1:1) to receive either the SOX regimen (n = 362) or the S-1 regimen (n = 362). The primary endpoint was overall survival. This study is registered with ClinicalTrials.gov (NCT01795027). FINDINGS: The median follow-up was 74.0 months (interquartile range [IQR], 35.5-89.3). The 5-year overall survival rates were 70.9% (95% confidence interval [CI], 66.0-76.1) in the SOX group and 62.9% (95% CI, 57.8-68.5) in the S-1 group (hazard ratio [HR], 0.74; 95% CI, 0.58-0.95; p = 0.018). The 3- and 5-year disease-free survival rates were 71.2% (95% CI, 66.5-76.3) and 66.2% (95% CI, 61.2-71.6) in the SOX group, as compared with 65.1% (95% CI, 60.2-70.5) and 55.6% (95% CI, 50.4-61.3) in the S-1 group (HR, 0.76; 95% CI, 0.61-0.96). Treatment-related adverse events of grade 3-4 occurred in 87 (25%) of 349 patients in the SOX group and 45 (13%) of 347 patients in the S-1 group. The most common grade 3-4 adverse event was neutropenia, occurring in 44 (13%) of 349 patients in the SOX group and 23 (7%) of 347 patients in the S-1 group. CONCLUSIONS: The addition of adjuvant oxaliplatin to S-1 chemotherapy significantly improved overall survival and disease-free survival in patients with gastric cancer. FUNDING: This research was supported by the National Natural Science Foundation of China (82573092 and 82573387).

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HumansStomach NeoplasmsOxaliplatinTegafurOxonic AcidDrug CombinationsFemaleChemotherapy, AdjuvantAntineoplastic Combined Chemotherapy ProtocolsMaleAdenocarcinomaMiddle AgedAgedGastrectomyNeoplasm StagingDisease-Free SurvivalEsophagogastric JunctionS-1adjuvant chemotherapygastric canceroxaliplatintranslation to patientsJournal ArticleRandomized Controlled TrialClinical Trial, Phase IIIMulticenter Study

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Run-Cong Nie, Shi Chen, Jin Wan, Xiao-Wei Sun, Wei-Qin Hong, Hong-Bo Wei, Wei Wang, Wen-Bin Zhang, Yan Zhao, Wei-Bin Zhang, Jing-Song Chen, Zu-Guang Wu, Cong Mai, Chun-Zai Feng, Shu-Qiang Yuan, Hai-Bo Qiu, Yao Liang, Yuan-Xiang Guan, Yong-Ming Chen, Wen-Wu Liu, Chao Ding, Jun-Sheng Peng, Ying-Bo Chen, Zhi-Wei Zhou, Yuan-Fang Li. 2026-08-14. Adjuvant oxaliplatin with S-1 (SOX) versus S-1 for stage II-III gastric cancer (CAPITAL): A randomized, open-label, phase 3 trial.. https://doi.org/10.1016/j.medj.2026.101258

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Aged subjectAntineoplastic Combined Chemotherapy Protocols subjectClinical Trial, Phase III subjectDrug Combinations subjectFemale subjectHumans subjectJournal Article subjectMale subjectMiddle Aged subjectMulticenter Study subjectRandomized controlled trials study

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