A randomized clinical trial on the antitumoral effects of low molecular weight heparin in the treatment of esophageal cancer

Abstract

The current treatment approaches for esophageal cancer are associated with poor survival, and there are ongoing efforts to find new and more effective therapeutic strategies. There are several reports on the antitumoral effects of low-molecular-weight heparins (LMWHs). We have assessed the possible survival benefit of LMWHs in esophageal malignancies. This was a randomized, singleblind, multicenter, Phase II clinical trial on nonmetastatic esophageal cancer candidate for neoadjuvant chemoradiotherapy. Patients were randomly assigned to the chemoradiotherapy-only arm or chemoradiotherapy plus enoxaparin arm using 1:1 allocation. Radiotherapy was delivered in 1.8-Gy daily fractions to a dose of 50.4 Gy in both groups. Paclitaxel 50 mg/m 2 and carboplatin (AUC 2) were administered weekly, concurrent with radiotherapy. In the intervention group, patients received enoxaparin (40 mg) and chemoradiation daily. 4-6 weeks after treatment, all patients underwent esophagectomy. After a median follow up of 7 months, estimated 1 year disease-free survival (DFS) in the intervention group was 78.9% and was 70% in the control groups (p = 0.5). Toxicity from the experimental treatment was minimal, and there were no treatment-related deaths. A pathologically complete response in intervention and control group was 64.8% and 62.5%, respectively (p = 0.9). There was a nonsignificant trend toward improved survival by the addition of enoxaparin to the concurrent chemoradiotherapy regimen. However, 1 y DFS of both groups were high as expected. A longer follow-up and a larger sample size are required. K E Y W O R D S anti-tumoral effects, clinical trail, esophageal cancer, low molecular weight heparin (LMWH)

Therapeutic potential of targeting the Wnt/β‐catenin pathway in the treatment of pancreatic cancer

“…There are ongoing efforts to find more individualized, more targeted, and more effective therapeutic approaches in the treatment of cancer. 57,58 The therapeutic potential of targeting the Wnt pathway in the treatment of some cancers has been reported previously. 50 To date, several agents have been proposed for the treatment of pancreatic cancer targeting the Wnt oncogenic signaling pathway, for example, PRI-724 (NCT01764477), OMP-18R5 (NCT02005315), OMP-54F28 (NCT02050178), and LGK974 (NCT01351103).…”

A case report of mediastinal cavernous hemangioma

“… 16 , 17 Besides, there are promising new data on the underlying molecular mechanisms of different cancer, which may affect the treatment of these benign tumors with the least side effects. 18 , 19 , 20 , 21 …”

A case report of endometrial adenocarcinoma with leptomeningeal metastases

“… 18 , 19 Besides, there are promising new data on the underlying molecular mechanisms of different cancers that may improve the outcome of patients with LM through introducing new drugs and treatment modalities. 20 , 21 , 22 , 23 , 24 …”