Neoadjuvant Chemo in Esophageal Cancer Misses Remission Goal

Neoadjuvant Chemo in Esophageal Cancer Misses Remission Goal

S0356:A Phase II Clinical and Prospective Molecular Trial With Oxaliplatin, Fluorouracil, and External-Beam Radiation Therapy Before Surgery for Patients With Esophageal Adenocarcinoma

Published online before print October 24, 2011, doi:10.1200/JCO.2011.36.7490JCO October 24, 2011JCO.2011.36.7490
M:oxaliplatin 85 mg/m² on days 1, 15, and 29; protracted-infusion fluorouracil (PI-FU) 180 mg/m²/d on days 8 through 43; and external-beam radiation therapy (EBRT) 5 days a week at 1.8 Gy/d for 25 fractions; surgery was performed 28 to 42 days after neoadjuvant therapy. Chemotherapy was planned after surgery. Tumors were analyzed for mRNA expression and polymorphisms in genes involved in drug metabolism and DNA repair.
Conclusion
Neoadjuvant oxaliplatin, PI-FU, and EBRT for esophageal adenocarcinoma is active and tolerable. Because the regimen failed to meet the primary end point, it does not define a new standard. However, future trials can be built on this platform to validate the role ofERCC-1 in determining the best systemic regimen for individual patients.