American journal of clinical oncology · 2026
Executive Summary of the American Radium Society (ARS) Appropriate Use Criteria (AUC) for Locoregional Gastric Adenocarcinoma.
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Tchelebi Leila, Jin Zhaohui, Attallah Joseph, Abood Gerard, Akselrod Dmitriy, Anker Christopher J, Codipilly D Chamil, Dozois Eric, Hallemeier Christopher L, Jethwa Krishan R, Kennedy Timothy, Lee Percy, Ling Diane, Miller Eric D, Newman Neil B, Sharma Navesh, Small William, Russo Suzanne, Expert Panel Adjuvant Therapy for Treatment of Locoregional Gastric Adenocarcinoma
Аннотация
OBJECTIVES: To summarize recent high-quality trials and provide an update to the original 2022 American College of Radiology Appropriate Use Criteria for Treatment of Locoregional Gastric Adenocarcinoma. This multi-specialty-led committee included gastrointestinal radiation and medical oncology, gastroenterology, radiology, and surgical oncology.
METHODS: Using the population, intervention, comparator, outcome, timing, and study design framework, the evidence was assessed using Cochrane and PRISMA 2020 methodology. Eligible studies included prospective Phase II/II trials and select retrospective studies published between 5/1/2020 and 8/1/2025 in the Embase, Medline, and Pubmed databases. Study type and quality were assessed. Well-established RAND-UCLA consensus methodology (modified Delphi) was used to rate the appropriateness of the treatment options.
RESULTS: ARS AUC recommendations include adjuvant FLOT chemotherapy for localized gastric adenocarcinoma after neoadjuvant FLOT and surgery, poCT or perioperative chemoimmunotherapy for localized gastric adenocarcinoma, adjuvant chemotherapy +/- CRT for localized gastric adenocarcinoma that undergoes upfront surgery, and systemic therapy alone for localized gastric adenocarcinoma in a medically inoperable patient.
CONCLUSIONS: This updated ARS AUC summary provides guidelines for the multimodality treatment of resectable gastric adenocarcinoma.
METHODS: Using the population, intervention, comparator, outcome, timing, and study design framework, the evidence was assessed using Cochrane and PRISMA 2020 methodology. Eligible studies included prospective Phase II/II trials and select retrospective studies published between 5/1/2020 and 8/1/2025 in the Embase, Medline, and Pubmed databases. Study type and quality were assessed. Well-established RAND-UCLA consensus methodology (modified Delphi) was used to rate the appropriateness of the treatment options.
RESULTS: ARS AUC recommendations include adjuvant FLOT chemotherapy for localized gastric adenocarcinoma after neoadjuvant FLOT and surgery, poCT or perioperative chemoimmunotherapy for localized gastric adenocarcinoma, adjuvant chemotherapy +/- CRT for localized gastric adenocarcinoma that undergoes upfront surgery, and systemic therapy alone for localized gastric adenocarcinoma in a medically inoperable patient.
CONCLUSIONS: This updated ARS AUC summary provides guidelines for the multimodality treatment of resectable gastric adenocarcinoma.