Survival outcomes from CALGB 80803 (Alliance): A randomized phase II trial of PET scan-directed combined modality therapy for esophageal cancer.

Goodman, Karyn A.; Hall, Nathan C.; Bekaii‐Saab, Tanios; Ou, Fang‐Shu; Twohy, Erin; Meyers, Michael O.; Boffa, Daniel J.; Mitchell, Kisha A.; Perry, Kyle A.; Frankel, Wendy L.; Venook, Alan P.; O'Reilly, Eileen Mary; Ilson, David H.

doi:10.1200/jco.2018.36.15_suppl.4012

Cited by 31 publications

(42 citation statements)

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“…Yet, “salvage” therapy was likely suboptimal, because cisplatin was administered with low‐dose radiation (32 Gy) despite an initial nonresponse to 5‐FU and cisplatin induction therapy. The previously described CALGB 80803 study evaluated whether changing to alternative chemotherapy during chemoradiation based on response to induction chemotherapy, as assessed by PET, may lead to improved pCR rates . In preliminary reporting, patients who were PET nonresponders and changed chemotherapy regimens had pCR rates of 17% to 19%, meeting the primary endpoint of improving the pCR rate from a historic control rate of 3%.…”

Section: Surgery For Early‐stage Diseasementioning

confidence: 99%

“…A 4-year OS of 52.7% was seen in PET responders to FOLFOX versus 44.7% in PET responders to carboplatin and paclitaxel. 19 Although the study was not powered to evaluate survival differences between regimens, these results are hypothesis-generating.…”

Section: Preoperative Chemoradiationmentioning

confidence: 99%

“…The previously described CALGB 80803 study evaluated whether changing to alternative chemotherapy during chemoradiation based on response to induction chemotherapy, as assessed by PET, may lead to improved pCR rates. 18,19 In preliminary reporting, patients who were PET nonresponders and changed chemotherapy regimens had pCR rates of 17% to 19%, meeting the primary endpoint of improving the pCR rate from a historic control rate of 3%. The median OS was 47.3 months in PET responders versus 28.9 months in PET nonresponders (P = .09).…”

Section: Metabolic Imaging To Guide Preoperative Therapymentioning

confidence: 99%

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Optimal management of gastroesophageal junction cancer

Greally

Agarwal

Ilson

2019

Cancer

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Although recent decades have witnessed incremental improvements in the treatment of gastroesophageal junction (GEJ) carcinoma, outcomes remain modest. For locally advanced esophageal cancer, the addition of chemotherapy and/or radiation to surgery is considered the standard of care. Chemotherapy remains the primary treatment for metastatic disease and improves survival over best supportive care. However, the prognosis for patients with GEJ cancers, which are treated along the same paradigms as esophageal and gastric carcinomas, remain poor because of the emergence of chemoresistance and limited targeted therapeutic approaches, which include agents that target the HER2 and vascular endothelial growth factor pathways. Evaluation of immune checkpoint inhibitors in the chemorefractory setting have confirmed the activity of immunotherapy in esophagogastric cancer. Ongoing immunotherapeutic strategies are being evaluated in both the locally advanced and metastatic settings. This review focuses on the treatment of locally advanced and metastatic GEJ carcinomas, which encompass all tumors that have an epicenter within 5 cm proximal or distal to the anatomical Z‐line (Siewert classification). Because the vast majority of GEJ tumors are adenocarcinoma, the management of adenocarcinoma is the focus of this review. Evolving approaches and areas of clinical equipoise are discussed.

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Section: Surgery For Early‐stage Diseasementioning

confidence: 99%

Section: Preoperative Chemoradiationmentioning

confidence: 99%

Section: Metabolic Imaging To Guide Preoperative Therapymentioning

confidence: 99%

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Optimal management of gastroesophageal junction cancer

Greally

Agarwal

Ilson

2019

Cancer

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“…15 Although the study was not designed to detect differences between the regimens, these results are hypothesis-generating. It is interesting to note that initial results from the phase 2 Cancer and Leukemia Group B (CALGB) 80803 study reported a pCR rate of 37.5% in patients who were positron emission tomography (PET) responders to induction leucovorin, 5-FU, and oxaliplatin (FOLFOX), and continued this with radiotherapy, compared with a pCR rate of 12.5% in PET responders to induction carboplatin and paclitaxel who received the same regimen with radiotherapy.…”

mentioning

confidence: 99%

“…15 We await the results of several comparative studies of perioperative chemotherapy and chemoradiation. Initial results of the CALGB 80803 study indicated that PET may be used to guide appropriate chemotherapy during radiation.…”

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confidence: 99%

Neoadjuvant therapy for esophageal cancer: Who, when, and what?

Greally

Ilson

2018

Cancer

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Evaluation of the Association of Perioperative UGT1A1 Genotype–Dosed gFOLFIRINOX With Margin-Negative Resection Rates and Pathologic Response Grades Among Patients With Locally Advanced Gastroesophageal Adenocarcinoma

et al. 2020

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IMPORTANCE Patients with locally advanced gastroesophageal adenocarcinoma (ie, stage ՆT3 and/or node positive) have high rates of recurrence despite surgery and adjunctive perioperative therapies, which also have high toxicity profiles. Evaluation of pharmacogenomically dosed perioperative gFOLFIRINOX (fluorouracil, leucovorin, oxaliplatin, and UGT1A1 genotype-directed irinotecan) to optimize efficacy while limiting toxic effects may have value. OBJECTIVE To evaluate the coprimary end points of margin-negative (R0) resection rates and pathologic response grades (PRGs) of gFOLFIRINOX therapy among patients with locally advanced gastroesophageal adenocarcinoma. DESIGN, SETTING, AND PARTICIPANTS This single-group phase 2 trial, conducted at 2 academic medical centers from February 2014 to March 2019, enrolled 36 evaluable patients with locally advanced adenocarcinoma of the esophagus, gastroesophageal junction, and gastric body. Data analysis was conducted in May 2019. INTERVENTIONS Patients received biweekly gFOLFIRINOX (fluorouracil, 2400 mg/m 2 over 46 hours; oxaliplatin, 85 mg/m 2 ; irinotecan, 180 mg/m 2 for UGT1A1 genotype 6/6, 135 mg/m 2 for UGT1A1 genotype 6/7, or 90 mg/m 2 for UGT1A1 genotype 7/7; and prophylactic peg-filgrastim, 6 mg) for 4 cycles before and after surgery. Patients with tumors positive for ERBB2 also received trastuzumab (6-mg/kg loading dose, then 4 mg/kg). MAIN OUTCOMES AND MEASURES Margin-negative resection rate and PRG. RESULTS A total of 36 evaluable patients (27 [78%] men; median [range] age, 66 [27-85] years; 10

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Survival outcomes from CALGB 80803 (Alliance): A randomized phase II trial of PET scan-directed combined modality therapy for esophageal cancer.

Cited by 31 publications

References 0 publications

Optimal management of gastroesophageal junction cancer

Optimal management of gastroesophageal junction cancer

Neoadjuvant therapy for esophageal cancer: Who, when, and what?

Evaluation of the Association of Perioperative UGT1A1 Genotype–Dosed gFOLFIRINOX With Margin-Negative Resection Rates and Pathologic Response Grades Among Patients With Locally Advanced Gastroesophageal Adenocarcinoma

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