Vinorelbine and cisplatin in metastatic squamous cell carcinoma of the oesophagus: response, toxicity, quality of life and survival

Conroy, Thierry; Étienne, Pierre; Adenis, Antoine; Ducreux, Michel; Oliveira, J.; Seitz, Jean‐François; François, Ετιεννε; Cutsem, Éric Van; Wagener, D.J.T.; Kohser, F.; Daamen, S.; Praet, Michel; Wils, J.

doi:10.1093/annonc/mdf063

Cited by 68 publications

(47 citation statements)

References 27 publications

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“…The combination of vinorelbine and cisplatin was tested only in metastatic patients, obtaining an RR of 34% with acceptable toxicity (Conroy et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Phase II trial of docetaxel, cisplatin and fluorouracil followed by carboplatin and radiotherapy in locally advanced oesophageal cancer

Chiarion-Sileni

Corti

Ruol³

et al. 2007

Br J Cancer

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This study was performed to assess the efficacy and safety of docetaxel, cisplatin and fluorouracil combination in patients with unresectable locally advanced oesophageal squamous cell carcinoma. Treatment consisted of docetaxel 60 mg m À2 , cisplatin 75 mg m À2 on day 1 and fluorouracil 750 mg m À2 day À1 on days 2 -5, repeated every 3 weeks for three cycles, followed by carboplatin 100 mg m À2 week À1 for 5 weeks and concurrent radiotherapy (45 Gy in 25 fractions, 5 days week À1 ). After radiotherapy, eligible patients either underwent an oesophagectomy or received high dose rate endoluminal brachytherapy (HDR-EBT). Thirty-one out of 37 enrolled patients completed the planned chemotherapy and 30 completed chemoradiation. After completion of chemotherapy, 49% (95% CI: 32.2 -66.2) had a clinical response. Twelve patients (32%) underwent a resection, which was radical in 60% (postoperative mortality: 0%). A pathological complete response was documented in four patients (11% of enrolled, 30% of resected). The median survival was 10.8 months (95% CI: 8.1 -12.4), and the 1-and 2-year survival rates were 35.1 and 18.9%, respectively. Grade 3 -4 toxicities were neutropoenia 32%, anaemia 11%, non-neutropoenic infections 18%, diarrhoea 6% and oesophagitis 5%. Nine patients (24%) developed a tracheo-oesophageal fistula during treatment. Even if the addition of docetaxel to cisplatin and 5-fluorouracil (5-FU) seems to be more active than the cisplatin and 5-FU combination, an incremental improvement in survival is not seen, and the toxicity observed in this study population is of concern. In order to improve the prognosis of these patients, new drugs, combinations and strategies with a better therapeutic index need to be identified.

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“…The combination of vinorelbine and cisplatin was tested only in metastatic patients, obtaining an RR of 34% with acceptable toxicity (Conroy et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Phase II trial of docetaxel, cisplatin and fluorouracil followed by carboplatin and radiotherapy in locally advanced oesophageal cancer

Chiarion-Sileni

Corti

Ruol³

et al. 2007

Br J Cancer

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“…These findings were primarily due to an improvement in emotional and social/family well-being scores. QoL was also assessed using the EORTC QLQ-C30 in 71 patients undergoing a vinorelbine-cisplatin regimen in metastatic squamous cell oesophageal carcinoma [50]. Response to chemotherapy was associated with an improvement in QoL scores, especially in global health status, physical and role function, fatigue and anorexia.…”

Section: Impact Of Non-surgical Treatments On Qolmentioning

confidence: 99%

Quality of Life in Patients with Oesophageal and Gastric Cancer: An Overview

2006

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An accurate assessment of health-related quality of life (QoL) in patients with oesophageal or gastric cancer (OGC) is essential to inform clinical decisions by providing insights into patients’ experiences of the impact of the disease and its treatments on physical, social and emotional health. Robust QoL questionnaires have been developed and validated in the past decade to measure the QoL of OGC patients. Baseline QoL variables are also prognostic for survival in patients with oesophageal cancer or metastatic gastric cancer. This article reviews the impact of surgery and reconstructive techniques, as well as of adjuvant and palliative treatments on the QoL of patients with OGC.

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“…Active agents include cisplatin, 5-FU, the taxanes, irinotecan, mitomycin C (Mutamycin ® ; Bristol-Myers Squibb), etoposide (Etopophos 592 Esophageal Cancer (30%-57%), with occasional patients achieving complete responses (0%-11%) [22][23][24][26][27][28][29]. However, with the combination regimens, the median survival time remains less than 10 months.…”

Section: Metastatic/unresectable Diseasementioning

confidence: 99%

Targeted Therapies for Esophageal Cancer

2005

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Esophageal cancer is a highly aggressive neoplasm. In 2005, 14,520 Americans will be diagnosed with esophageal cancer, and more than 90% will die of their disease. On a global basis, cancer of the esophagus is the sixth leading cause of cancer death worldwide. In fact, gastric and esophageal cancers together accounted for nearly 1.3 million new cases and 980,000 deaths worldwide in 2000-more than lung, breast, or colorectal cancer. Although esophageal squamous cell carcinoma cases have steadily declined, the incidence of gastroesophageal junction adenocarcinoma has increased 4%-10% per year among U.S. men since 1976, more rapidly than for any other cancer type, and parallels rises in population trends in obesity and reflux disease. With advances in surgical techniques and treatment, the prognosis of esophageal cancer has slowly improved over the past three decades. However, the 5-year overall survival rate (14%) remains poor, even in comparison with the dismal survival rates (4%) from the 1970s. The underlying reasons for this disappointingly low survival rate are multifold: (a) ineffective screening tools and guidelines; (b) cancer detection at an advanced stage, with over 50% of patients with unresectable disease or distant metastasis at presentation; (c) high risk for recurrent disease after esophagectomy or definitive chemoradiotherapy; (d) unreliable noninvasive tools to measure complete response to chemoradiotherapy; and (e) limited survival achieved with palliative chemotherapy alone for patients with metastatic or unresectable disease. Clearly, additional strategies are needed to detect esophageal cancer earlier and to improve our systemic treatment options. Over the past decade, the field of drug development has been transformed with the identification of and ability to direct treatment at specific molecular targets. This review focuses on novel targeted treatments in development for esophageal squamous cell carcinoma and distal esophageal and gastroesophageal junction adenocarcinoma. The Oncologist 2005:590-601Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME This material is protected by U.S.

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Vinorelbine and cisplatin in metastatic squamous cell carcinoma of the oesophagus: response, toxicity, quality of life and survival

Abstract: Vinorelbine plus cisplatin represents a well-tolerated active palliative regimen for patients with advanced squamous cell carcinoma of the oesophagus. This combination may offer a better therapeutic index than cisplatin-5-fluorouracil.

Cited by 68 publications

References 27 publications

Phase II trial of docetaxel, cisplatin and fluorouracil followed by carboplatin and radiotherapy in locally advanced oesophageal cancer

Phase II trial of docetaxel, cisplatin and fluorouracil followed by carboplatin and radiotherapy in locally advanced oesophageal cancer

Quality of Life in Patients with Oesophageal and Gastric Cancer: An Overview

Targeted Therapies for Esophageal Cancer

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