A retrospective study of adjuvant albumin-bound paclitaxel plus S-1 after D2 gastrectomy versus oxaliplatin plus S-1 in gastric cancer - open access research report

Sep 22, 2026

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Adjuvant oxaliplatin plus S-1 (SOX) after D2 gastrectomy improves survival in gastric cancer, but the efficacy of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) plus S-1 remains unclear. This single-center retrospective study compared nab-paclitaxel plus S-1 versus SOX in patients treated between January 2018 and December 2020. The primary outcomes were 3-year disease-free survival and adverse events. Overall, 3-year DFS was 78.0% versus 70.7% (p=0.46), with signet-ring positive patients showing longer DFS under the AS regimen.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Background

Clinical rationale for adjuvant chemotherapy after D2 gastrectomy

Evidence from prior phase III trials

Study Design and Treatment Regimens

Patient recruitment and treatment groups

Dosing schedules for nab-paclitaxel or oxaliplatin with S-1

Outcomes and Safety

Disease-free survival at 3 years

Subgroup analysis by tumor characteristics

Adverse events and toxicity grades

[www. nature.com/scientificreports](www. nature.com/scientificreports) OPEN A retrospective study of adjuvant albumin‑bound paclitaxel plus S‑1 after D2 gastrectomy versus oxaliplatin plus S‑1 in gastric cancer Ning Li1,2, Hui Wu1,2, Xin Xu1,2, Qinming Wei1, Yongfeng Ding1, Shan Liu1, Jinqiong Wu1, Yulong Zheng1, Nong Xu1, Yuan Gao1 & Haiping Jiang1* Adjuvant oxaliplatin plus S‑1 (SOX) chemotherapy for gastric cancer (GC) after D2 gastrectomy has been proven effective. There has yet to be a study that evaluates adjuvant nanoparticle albumin‑ bound paclitaxel (nab‑paclitaxel) plus S‑1. In this single‑center, retrospective study, GC patients after D2 gastrectomy received either nab‑paclitaxel plus S‑1 (AS group) or SOX group were recruited between January 2018 and December 2020 in The First Affiliated Hospital of Zhejiang University. Intravenous nab‑paclitaxel 120 mg/m2 or 260 mg/m2 and oxaliplatin 130 mg/m2 were administered as eight 3 week cycle, especially in theAS and SOX group. Patients received S‑1 twice daily with a dose of 40 mg/m2 in the two groups on days 1–14 of each cycle. The end points were disease‑free survival (DFS) rate at 3 years and adverse events (AEs). There were 56 eligible patients, 28 in the AS group and 35 in the SOX group. The 3 year DFS rate was 78.0% in AS group versus 70.7% in SOX group (p = 0.46). Subgroup analysis showed that the patients with signet‑ring positive in the AS group hada prolonged DFS compared with the SOX group (40.0 vs. 13.8 m, p= 0.02). The diffuse‑type GC or low differentiation in the AS group was associated with numerically prolonged DFS compared with the SOX group, but the association was not statistically significant (p = 0.27 and p = 0.15 especially) . Leukopenia (14.3%) were the most prevalent AEs in the AS group, while thrombocytopenia (28.5%) in the SOX group. Neutropenia (7.1% in AS group) and thrombocytopenia (22.8% in SOX group) were the most common grade 3 or 4 AEs. In this study analyzing past data, a tendency towards a greater 3 year DFS was observed when using AS regimen in signet‑ring positive patients. AS group had fewer thrombocytopenia compared to SOX group. More studies should be conducted with larger sample sizes. Keywords Gastric cancer, Adjuvant chemotherapy, Albumin-bound paclitaxel, S-1, Disease free survival Worldwide, there are more than one million fresh instances of gastric cancer (GC), placing it fifth in terms of occurrence and fourth in terms of fatality1. In 2020, it was estimated that there were 769,000 deaths (equivalent to one in every 13 deaths) . There is a two-fold increase in male rates compared to female rates. There is a serious burden of GC in China due to its high incidence. According to the latest data2, GC ranked as the third most prevalent cancer and the third leading cause of cancer-related deaths in China in 2022. Surgery represents the primary treatment option for managing early-stage and locally advanced GC. Recurrence rates following surgery are high, with approximately 40% of patients experiencing relapse within two years after surgery. GC spreads through the lymphatic system, bloodstream, and peritoneum early in the disease process3. Different adjuvant treatments have been investigated for decades to enhance post-surgical relapse control. Several large phase III clinical studies have demonstrated that adjuvant chemotherapy after D2 radical resection can improve survival outcomes in GC patients4–6. The trial showed that S-1 monotherapy as adjuvant chemotherapy provided a survival advantage for stage II-III GC4. Based on the CLASSIC study, oxaliplatin 1The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310001, China. 2These authors contributed equally: Ning Li, Hui Wu and Xin Xu.*[email: jianghaiping@zju.edu.cn](email: jianghaiping@zju.edu.cn) [www. nature.com/scientificreports/](www. nature.com/scientificreports/) combined with capecitabine (CapOx) was recommended as a postoperat

FAQs

What was the main comparison in this study?

The study compared adjuvant albumin-bound paclitaxel (nab-paclitaxel) plus S-1 versus oxaliplatin plus S-1 after D2 gastrectomy in gastric cancer patients.

What were the primary endpoints?

Primary endpoints were 3-year disease-free survival (DFS) rate and adverse events (AEs).

Did nab-paclitaxel plus S-1 improve outcomes overall?

Overall 3-year DFS was numerically higher with the AS regimen (78.0%) than with SOX (70.7%), but the difference was not statistically significant (p=0.46).

Sep 22, 2026

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