{"entity":{"id":"paper-classic-adjuvant-capox-gastric-bang-lancet-2012","kind":"paper","name":"CLASSIC: adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy","aka":[],"tldr":"Six months of capecitabine and oxaliplatin after a D2 gastrectomy raised three-year disease-free survival from 59 to 74 percent in East Asian patients with stage II to III stomach cancer.","summary":"Open-label phase 3 trial at 37 centres in South Korea, China and Taiwan: 1,035 patients with stage II to IIIB gastric cancer after curative D2 gastrectomy were randomised to eight cycles of capecitabine and oxaliplatin (520) or observation (515).\n\nThree-year disease-free survival was 74 percent with chemotherapy against 59 percent with surgery alone (hazard ratio 0.56). Grade 3 or 4 adverse events occurred in 56 percent of chemotherapy patients against 6 percent of surgery-only patients, most commonly nausea, neutropenia and decreased appetite.","asOf":"2026-09-22","links":[{"label":"Lancet 2012","url":"https://doi.org/10.1016/S0140-6736(11)61873-4"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/22226517/"}],"tags":[],"related":[],"cancers":["gastric"],"sections":[],"technologies":[],"targets":[],"drugs":["capecitabine","oxaliplatin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["classic"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2012,"doi":"10.1016/S0140-6736(11)61873-4","pmid":"22226517","authors":"Bang YJ, Kim YW, Yang HK, et al.","paperType":"rct","findings":["Three-year disease-free survival 74 percent (95% CI 69 to 79) versus 59 percent (53 to 64); hazard ratio 0.56 (0.44 to 0.72), p < 0.0001.","Grade 3 or 4 adverse events 56 percent versus 6 percent."],"whatItMeans":"Adjuvant CAPOX after D2 gastrectomy is a standard option for operable stage II to III gastric cancer, alongside S-1 in Japan.","caveats":["East Asian population with D2 surgery; Western practice relies on perioperative chemotherapy (FLOT) instead.","Open-label design."],"changedPractice":true,"participants":1035},"route":"/key-papers/paper-classic-adjuvant-capox-gastric-bang-lancet-2012/","neighbours":{"cancer":[{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"}],"drug":[{"id":"capecitabine","kind":"drug","name":"Capecitabine","route":"/drugs/capecitabine/"},{"id":"oxaliplatin","kind":"drug","name":"Oxaliplatin","route":"/drugs/oxaliplatin/"}],"trial":[{"id":"classic","kind":"trial","name":"CLASSIC","route":"/trials/classic/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}]}}