6/28/23, 11:16 PM MAGIC Pathway Feedback Search Clinical Topics Home Studies MAGIC MAGIC Disease Disease Esophageal cancer Gastric cancer Trial question Is perioperative chemotherapy plus surgery superior to surgery alone in patients with resectable gastroesophageal cancer? Study design Multi-center Open label RCT Population Characteristics of study participants 21.0% female N = 503 79.0% male 503 patients (107 female, 396 male) Inclusion criteria: patients with resectable adenocarcinoma of the stomach, esophagogastric junction, or lower esophagus Key exclusion criteria: receipt of cytotoxic chemotherapy or radiotherapy; uncontrolled cardiac disease; CrCl 60 ml/min Interventions N=250 perioperative chemotherapy plus surgery (A regimen consisting of epirubicin, cisplatin, and fluorouracil for three cycles perioperatively and three cycles postoperatively plus surgery) N=253 surgery alone (surgery alone without chemotherapy) https://web.pathway.md/studies/recrx0m339kJu6u0W 1/2 6/28/23, 11:16 PM MAGIC Pathway Primary outcome Overall survival 40.4 % 40.4 32.8 30.3 % 20.2 % 10.1 % Borderline significant increase 0.0 % Perioperative chemotherapy plus surgery Surgery alone Borderline significant increase in overall survival (40.4% vs. 32.8%; HR 1.33, 95% CI 1.06 to 1.67) Secondary outcomes Significant decrease in diameter of resected tumor (3 cm vs. 5 cm; AD -2 cm, 95% CI -3.19 to -0.81) Safety outcomes No significant differences in postoperative complications, deaths within 30 days after surgery. Conclusion In patients with resectable adenocarcinoma of the stomach, esophagogastric junction, or lower esophagus, perioperative chemotherapy plus surgery was superior to surgery alone with respect to overall survival. Reference David Cunningham, William H Allum, Sally P Stenning et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006 Jul 6;355(1):11-20. Open reference URL https://web.pathway.md/studies/recrx0m339kJu6u0W 2/2