Neoadjuvant Gastric Score for prediction of overall survival and adjuvant therapy benefit in locally advanced gastric adenocarcinoma

The Neoadjuvant Rectal Score (NAR) was developed as a short-term surrogated for 5-years overall survival prediciton in locally advanced rectal cancer on the basis of response to neoadjuvant therapy. Analysis of the National Cancer Database found that this score can be repurposed for locally advanced gastric adenocarcinoma treated with neoadjuvant chemotherapy followed by surgical resection. NAG scores stratified patients in three groups with significantly different 5-year overall survival after propensity score matching. Patients in the low- and intermediate-NAG groups had no OS benefit from adjuvant therapy, whereas patients in the high-NAG group had a five-year OS benefit with adjuvant therapy (39% versus 29%; p=0.024). The authors conclude that NAG score can be used as a prognostic tool in locally advanced gastric adenocarcinoma and has the potential to guide decision-making regarding allocation of adjuvant therapy.