A Phase II Study of Sequential Neoadjuvant Gemcitabine and Paclitaxel, Radiation Therapy With Cisplatin and 5-Fluorouracil and Surgery in Locally Advanced Esophageal Carcinoma

Lowy, Andrew M.; Firdaus, Irfan; Roychowdhury, Debasish; Redmond, Kevin P.; Howington, John A.; Sussman, Jeffrey J.; Safa, Malek M.; Ahmad, Syed A.; Reed, Michael F.; Rose, Patricia; James, Laura E.; Jazieh, Abdul Rahman

doi:10.1097/01.coc.0000233997.36073.8e

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…However, the use of neoadjuvant chemotherapy without the addition of radiotherapy is not generally accepted for AEG I. In many institutions, additional or sequential radiotherapy is delivered [4][5][6][7], but a recent meta-analysis gives justification for both the neoadjuvant chemotherapy and chemoradiotherapy approach in the treatment of resectable adenocarcinomas of the esophagus [8]. However, there is some evidence that the addition of radiation therapy might increase the risk of postoperative morbidity and mortality, which may be due to stronger immunosuppression in comparison to preoperative chemotherapy alone [9,10].…”

Section: Paclitaxel In the Neoadjuvant Treatment For Adenocarcinoma Omentioning

confidence: 99%

Paclitaxel in the Neoadjuvant Treatment for Adeno carcinoma of the Distal Esophagus (AEG I). A Comparison of Two Phase II Trials with Long-Term Follow-Up

Bader

Lordick

Fink³

et al. 2008

Onkologie

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Introduction: We report a comparative analysis of 2 sequential, prospective phase II trials on the efficacy of platinum/leucovorin/5-fluorouracil (PLF) +/– paclitaxel (T-PLF) in the neoadjuvant treatment of adenocarcinoma of the esophagus (AEG I). Patients and Methods: Inclusion criteria were histologically proven, locally advanced AEG I stage uT3/4 anyN cM0/M1a. 67 patients were treated with either PLF (n = 32) or T-PLF (n = 35). Paclitaxel (80 mg/m²) was added to PLF on days 1, 15, and 29. Primary endpoint was the response. Additionally, 5-year survival was analyzed. Results: The study population was well balanced, apart from an imbalance in clinical cM1a (33.3% PLF vs. 8.6% T-PLF; p = 0.01). Histopathological response rates (23.3% PLF vs. 25.0% T-PLF) showed no significant difference. Clinical response rates were improved for T-PLF (21.9 vs. 45.7%; p = 0.04). Median overall survival for clinical and histopathological responders was significantly improved for T-PLF (p = 0.005, p = 0.01), but not for PLF (p = 0.08, p = 0.25). Median overall survival was better with T-PLF without reaching statistical significance (18.9 months PLF vs. 43.1 months T-PLF; p = 0.27). Toxicity was slightly increased by paclitaxel. No treatment-related deaths occurred. Conclusion: Our data failed to demonstrate statistically significant superiority of the T-PLF regimen except for clinical response. However, there was a trend towards improved survival.

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Section: Paclitaxel In the Neoadjuvant Treatment For Adenocarcinoma Omentioning

confidence: 99%

Paclitaxel in the Neoadjuvant Treatment for Adeno carcinoma of the Distal Esophagus (AEG I). A Comparison of Two Phase II Trials with Long-Term Follow-Up

Bader

Lordick

Fink³

et al. 2008

Onkologie

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“…Malignant tumors could endanger human health (11,12). Although diagnosis and therapy of CRC had advanced rapidly, five-year survival rate of advanced CRC patients didn't have any significant progress (13).…”

Section: Discussionmentioning

confidence: 99%

Identification of Differentially Expressed Proteins of Normal and Cancerous Human Colorectal Tissues by Liquid Chromatograph-Mass Spectrometer Based on iTRAQ Approach

Fan

Wang

et al. 2015

Cancer Investigation

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Liquid chromatograph-mass spectrometer (LC/MS) based labeled with isobaric mass tags for relative and absolute quantitation (iTRAQ) analyses were performed to identify differentially expressed proteins from normal and cancerous human colorectal tissues. Around 802 proteins were identified, 68 proteins of which were defined as differentially expressed proteins. Bioinformatics analysis indicated that these differentially expressed proteins correlated with several specific cellular processes and pathways which have relationships with pathological changes of colorectal cancer (CRC). EHD2 were selected to verify its expression patterns and localization using western blotting and immunohistochemistry respectively. LC/MS-based iTRAQ proteomic approach would provide new information about the character of CRC.

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“…Findings of those studies suggest that gemcitabine alone or as gemcitabine-cisplatin combination were tolerable. However, gemcitabine with irinotecan or gemcitabine with paclitaxel was highly toxic (12,13). Furthermore, there were no additional survival benefits.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological significance of deoxycytidine kinase expression in esophageal squamous cell carcinoma

Shimada

Okumura

Sekine

et al. 2013

Molecular and Clinical Oncology

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Deoxycytidine kinase (dCK) mediates the rate-limiting catabolic step in the activation of gemcitabine. Gemcitabine is a key drug for pancreatic and biliary tract cancer. However, gemcitabine is not widely used for esophageal squamous cell carcinoma (ESCC). In this study, we analyzed the expression of dCK in ESCC and evaluated the possibility of gemcitabine treatment for ESCC. In total, 76 ESCC patients who underwent esophagectomy between 1990 and 2008 were analyzed. dCK expression was analyzed immunohistochemically using tissue microarray and compared to the clinocopathological characteristics of the patients. Results identified 41 patients positive for dCK and 35 patients negative for dCK. A significant association was observed between dCK expression and gender (P=0.01), whereas the remaining factors were not associated with dCK expression. Prognosis of the patients with a high dCK expression was significantly worse than that of the patients with a low dCK expression (P=0.022). Furthermore, dCK expression was an independent prognostic factor regarding cause-specific prognosis (risk ratio, 2.2; P=0.031). In conclustion, the results of the present study suggested that dCK expression is a prognostic factor of the ESCC patients.

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A Phase II Study of Sequential Neoadjuvant Gemcitabine and Paclitaxel, Radiation Therapy With Cisplatin and 5-Fluorouracil and Surgery in Locally Advanced Esophageal Carcinoma

Cited by 6 publications

References 27 publications

Paclitaxel in the Neoadjuvant Treatment for Adeno carcinoma of the Distal Esophagus (AEG I). A Comparison of Two Phase II Trials with Long-Term Follow-Up

Paclitaxel in the Neoadjuvant Treatment for Adeno carcinoma of the Distal Esophagus (AEG I). A Comparison of Two Phase II Trials with Long-Term Follow-Up

Identification of Differentially Expressed Proteins of Normal and Cancerous Human Colorectal Tissues by Liquid Chromatograph-Mass Spectrometer Based on iTRAQ Approach

Clinicopathological significance of deoxycytidine kinase expression in esophageal squamous cell carcinoma

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