Induction chemotherapy followed by surgery for advanced oesophageal cancer

Toxopeus, Eelke; Talman, S.; Gaast, Ate van der; Spaander, Manon; Rij, Caroline M. van; Krak, Nanda C.; Biermann, Katharina; Tilanus, Hugo W.; Mathijssen, Ron H.J.; Lanschot, J. Jan B. van; Wijnhoven, Bas P. L.

doi:10.1016/j.ejso.2014.11.043

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…In patients in whom nCRT followed by surgery is expected to be non-curative, as can be the case in unresectable bulky primary tumors or lymph node metastases outside the planned radiotherapy or surgical field, treatment with induction chemotherapy can be considered. Induction chemotherapy with paclitaxel and carboplatin or paclitaxel and cisplatin is able to downstage the tumor, achieving a resectable tumor in some patients [5].…”

Section: Introductionmentioning

confidence: 99%

The effectivity of targeted therapy and immunotherapy in patients with advanced metastatic and non-metastatic cancer of the esophagus and esophago-gastric junction

et al. 2022

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Therapies that target specific tumor drivers or immune checkpoints are increasingly explored for esophageal cancer patients. This review addresses developments in therapies with targeted anti-human epidermal growth factor receptor 2 (HER2) agents and immune checkpoint inhibitors in patients with stage IV esophageal cancer. First-line palliative treatment with the anti-HER2 agent trastuzumab in combination with chemotherapy has been approved for use in patients with HER2 positive gastro-esophageal adenocarcinoma. Neoadjuvant chemoradiotherapy plus perioperative trastuzumab however has not demonstrated a survival benefit in advanced esophageal cancer patients eligible for surgery. Potentially better responses are expected with dual agent anti-HER2 therapy instead of monotherapy. In the metastatic setting, the antibody–drug conjugate trastuzumab deruxtecan is effective after progression on trastuzumab. Nivolumab and pembrolizumab, antibodies blocking the programmed cell death 1 (PD-1) receptor on T cells, have recently gained approval for clinical use in esophageal cancer patients for specific indications. Synergistic effects might be achieved with combinations of immune checkpoint inhibitors that target PD-1 on T cells or PD ligand 1 (PD-L1) on tumor cells and anti-cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) receptor on T cells. Multiple clinical trials investigating combinations of targeted and immunotherapies, with or without (neo)adjuvant chemo(radio)therapy, for curative and palliative treatment, are underway, and are expected to deliver a long-awaited improvement in the prognosis of esophageal cancer patients.

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Section: Introductionmentioning

confidence: 99%

The effectivity of targeted therapy and immunotherapy in patients with advanced metastatic and non-metastatic cancer of the esophagus and esophago-gastric junction

et al. 2022

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“…In another 30% of patients, partial regression of the tumor is observed (1–10% vital tumor cells), while in 25% of patients the resection specimen does not show changes in regression (>50% of vital tumor cells). In patients with extensive disease not amenable for surgery, induction or palliative chemotherapy (iCT or pCT, respectively) is given, where paclitaxel is also combined with carboplatin [8,9,10,11]. In this setting, the dose of paclitaxel is higher (weekly 100 mg/m 2 ) than in the neoadjuvant setting (weekly 50 mg/m 2 ).…”

Section: Introductionmentioning

confidence: 99%

Association between Paclitaxel Clearance and Tumor Response in Patients with Esophageal Cancer

Toxopeus

Man

Krak

et al. 2019

Cancers

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Inter-individual variability in paclitaxel pharmacokinetics may play a role in the response to chemotherapy. Therefore, we studied the association between paclitaxel clearance and treatment response in patients with esophageal cancer. All patients who received paclitaxel (plus carboplatin) treatment for esophageal cancer between 2007 and 2013 were included. The treatment was given as neoadjuvant chemoradiotherapy (nCRT), induction chemotherapy (iCT), or palliative chemotherapy (pCT). The treatment response was assessed by the tumor regression grade (TRG) or by the RECIST1.1 criteria, respectively. The unbound paclitaxel clearance (CL) was estimated with NONMEM. The log-transformed clearance was related to response with ANOVA and independent sample t-tests. A total of 166 patients were included, of whom 113 received nCRT, 23 iCT and 30 pCT. In patients receiving nCRT, paclitaxel clearance was not associated with tumor regression grade (p-value = 0.25), nor with pathologically complete response (geometric mean 561.6 L/h) and residual disease (geometric mean 566.1 L/h, p-value = 0.90). In patients who underwent iCT or pCT, also no association between paclitaxel clearance and RECIST outcome was identified (iCT: p-value = 0.08 and pCT: p-value = 0.81, respectively). In conclusion, systemic paclitaxel exposure was not associated with response to common paclitaxel-based treatment regimens for esophageal cancer. Future studies should focus on tumor exposure in relation to systemic exposure and treatment outcome.

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Management of Esophageal Dysplasia and Esophageal Adenocarcinoma

Ghosh,

Tapias,

et al. 2024

Gastrointestinal Oncology ‐ a Critical Multidisciplinary Team Approach 2e

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Induction chemotherapy followed by surgery for advanced oesophageal cancer

Cited by 5 publications

References 29 publications

The effectivity of targeted therapy and immunotherapy in patients with advanced metastatic and non-metastatic cancer of the esophagus and esophago-gastric junction

The effectivity of targeted therapy and immunotherapy in patients with advanced metastatic and non-metastatic cancer of the esophagus and esophago-gastric junction

Association between Paclitaxel Clearance and Tumor Response in Patients with Esophageal Cancer

Management of Esophageal Dysplasia and Esophageal Adenocarcinoma

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