Combining precision medicine and prophylaxis in oesophageal squamous cell carcinoma

Baxter, Mark; Spender, Lindsay C.; Petty, Russell

doi:10.1038/s41416-020-01057-3

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…Furthermore, it can play a vital role in determining treatment efficacy in a research setting and boost the impact of clinical trials due to improved patient inclusion 10. Finally, in the clinical setting, it can augment clinician decision-making by improving treatment selection for each patient and potentially pave the way for precision medicine in esophageal cancer, particularly with the rise of novel therapies (eg, gene therapy and immune checkpoint inhibitors) 6,45…”

Section: Discussionmentioning

confidence: 99%

“…10 Finally, in the clinical setting, it can augment clinician decisionmaking by improving treatment selection for each patient and potentially pave the way for precision medicine in esophageal cancer, particularly with the rise of novel therapies (eg, gene therapy and immune checkpoint inhibitors). 6,45 Recurrence postesophagectomy poses a severe risk for patients, strongly influencing long-term survival, and often occurs before patient rehabilitation is complete. 17 Thus, identification of a patient group that is at high risk of recurrence is vital.…”

Section: Discussionmentioning

confidence: 99%

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Predicting Long-term Survival and Time-to-recurrence After Esophagectomy in Patients With Esophageal Cancer

et al. 2022

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Objective: To develop prediction models to predict long-term survival and time-to-recurrence following surgery for esophageal cancer. Background: Long-term survival after esophagectomy remains poor, with recurrence common. Prediction tools can identify high-risk patients and optimize treatment decisions based on their prognostic factors. Methods: Patients undergoing curative surgery from the European iNvestigation of SUrveillance After Resection for Esophageal Cancer study were included. Prediction models were developed for overall survival (OS) and disease-free survival (DFS) using Cox proportional hazards (CPH) and random survival forest (RSF). Model performance was evaluated using discrimination [time-dependent area under the curve (tAUC)] and calibration (visual comparison of predicted and observed survival probabilities). Results: This study included 4719 patients with an OS of 47.7% and DFS of 40.9% at 5 years. Sixteen variables were included. CPH and RSF demonstrated good discrimination with a tAUC of 78.2% [95% confidence interval (CI): 77.4%–79.1%] and 77.1% (95% CI: 76.1%–78.1%) for OS and a tAUC of 79.4% (95% CI: 78.5%–80.2%) and 78.6% (95% CI: 77.5%–79.5%), respectively for DFS at 5 years. CPH showed good agreement between predicted and observed probabilities in all quintiles. RSF showed good agreement for patients with survival probabilities between 20% and 80%. Conclusions: This study demonstrated that a statistical model can accurately predict long-term survival and time-to-recurrence after esophagectomy. Identification of patient groups at risk of recurrence and poor long-term survival can improve patient outcomes by optimizing treatment methods and surveillance strategies. Future work evaluating prediction-based decisions against standard decision-making is required to understand the clinical utility derived from prognostic model use.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predicting Long-term Survival and Time-to-recurrence After Esophagectomy in Patients With Esophageal Cancer

et al. 2022

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“…As the quality of life has become an increasingly important outcome parameter, trial designs as well as therapeutic approaches are altered to maintain high standards of the quality of life as a major treatment aim. Thus, novel treatment approaches combining precision medicine with current treatment options are underway [ 57 ].…”

Section: Future Perspective and Discussionmentioning

confidence: 99%

Immunotherapy for Esophageal Cancers: What Is Practice Changing in 2021?

Puhr

Preusser

2021

Cancers

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The prognosis of advanced esophageal cancer is dismal, and treatment options are limited. Since the first promising data on second-line treatment with checkpoint inhibitors in esophageal cancer patients were published, immunotherapy was surmised to change the face of modern cancer treatment. Recently, several studies have found this to be true, as the checkpoint inhibitors nivolumab and pembrolizumab have achieved revolutionary response rates in advanced as well as resectable settings in esophageal cancer patients. Although the current results of large clinical trials promise high efficacy with tolerable toxicity, desirable survival rates, and sustained quality of life, some concerns remain. This review aims to summarize the novel clinical data on immunotherapeutic agents for esophageal cancer and provide a critical view of potential restrictions for the implementation of these therapies for unselected patient populations.

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“…Most research so far has understandably focused on the role of PD-L1/PD-1. However, other biomarkers within the tumour microenvironment warrant investigation ( Figure 1 ) ( 12 , 15 ). For example, epidermal growth factor receptor (EGFR) is overexpressed in 30–70% of ESCC tumours ( 14 , 16 ).…”

mentioning

confidence: 99%

Immune checkpoint inhibition in advanced esophageal squamous cell carcinoma: how can we personalise management?

Cagney¹,

Petty²,

Baxter³

2023

J Thorac Dis

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Combining precision medicine and prophylaxis in oesophageal squamous cell carcinoma

Cited by 3 publications

References 11 publications

Predicting Long-term Survival and Time-to-recurrence After Esophagectomy in Patients With Esophageal Cancer

Predicting Long-term Survival and Time-to-recurrence After Esophagectomy in Patients With Esophageal Cancer

Immunotherapy for Esophageal Cancers: What Is Practice Changing in 2021?

Immune checkpoint inhibition in advanced esophageal squamous cell carcinoma: how can we personalise management?

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