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Background We evaluated whether the addition of docetaxel (D) to a combination comprising 5-fluorouracil/leucovorin (5-FU/LV) or capecitabine (C) plus oxaliplatin (O) (DOF/DOX) improved overall survival (OS) compared with 6 months of 5-fluorouracil (5-FU) or capecitabine in combination with oxaliplatin (FOLFOX/CAPOX) alone in advanced HER2-negative gastroesophageal junction and gastric adenocarcinomas (G/GEJ). Methods This study was an investigator-initiated, open-label, multi-institutional, randomized phase III trial in adult patients with HER2-negative advanced G/GEJs. The primary endpoint of the study was a comparison of median OS by Kaplan-Meier method. Next-generation sequencing was performed on tissue. Results Of the 324 patients randomly assigned between July 2020 and November 2022, 305 patients were evaluable for analysis (FOLFOX/CAPOX: 156; DOF/DOX: 149). With a median follow-up time of 19.2 months (95% Confidence Interval [CI] = 16.5 months to 21.9 months) for the entire cohort, the median OS was 10.1 months (95% CI = 9.2 to 10.9) for FOLFOX/CAPOX and 8.9 months (95% CI = 7.3 to 10.5) for DOF/DOX, and this difference was not statistically significant (P  = .70). An increased proportion of grade 3 or grade 4 neutropenia (21% vs 3%; P  < .001) and grade 2/3 neuropathy (17% vs 7%; P  = .005) was seen in patients receiving DOF/DOX. Genomic profiling revealed a low incidence of microsatellite instability (1%) and a high incidence of BRCA1 (8.4%) and BRCA2 (7.5%) somatic alterations. Conclusion FOLFOX or CAPOX chemotherapy for 6 months remains one of the standards of care in advanced HER2-negative gastroesophageal junction and gastric adenocarcinomas, with no additional survival benefit seen with the addition of docetaxel. Genomic profiling of patients revealed a higher than previously known incidence of somatic BRCA alterations, which requires further evaluation. CTRI (Clinical Trial Registry of India: CTRI/2020/03/023944). [ABSTRACT FROM AUTHOR]

Background: Neuropathic pain is defined by International Association tor the Study of Pain (IASP) as "Pain caused by a lesion or disease of the somatosensory nervous system". Elderly patients generally have high incidence of chronic neuropathic pain. The safe and effective treatment for chronic pain is a large public health concern. Palmitoylethanolamide (PEA) is an endogenously produced amide cannabimimetic compound with tissue protection and anti-inflammatory activity. Objectives: The aim & objective of this study is to evaluate the effectiveness and safety of Palmitoylethanolamide (PEA) in patients suffering from Neuropathic/Chronic Pain. Study Designed: Prospective Study. Materials and Methods: The Study was conducted in the Neurosurgery unit of Surgery Department in Gandhi Medical College & Associated Hamidia Hospital, Bhopal. A total no. of 150 patients aged 20-78 years were included in the study and divided into two groups, group I (Study group) and the group II (Control group) PEA was given to group I to evaluate the effect of PEA in neuropathic pain. Result: We studied 150 patients with PEA for 60 days in a dose of 354 mg orally three times (TDS) a day lor first 10 days and then two times (BID) a day for 50 days. It is available in India by the name of Palmiges. PEA was associated with greater pain reduction in the study group compared to the placebo controlled group. The primary outcome measured was the mean pain reduction evaluated by VAS scale. Conclusion: PEA seems to be useful in the treatment of neuropathic / chronic pain and it is well tolerated in patients in study group. Palmiges PEA reduces the inflammation in neuropathic pain, which results in lowering/reduction of neuropathic pain. Controlled trials are further needed to prove efficacy and reliability and also to find out the adverse reaction associated with the drug. [ABSTRACT FROM AUTHOR]