Neoadjuvant chemoradiotherapy for resectable oesophageal cancer

Eyck, Ben M; Wilk, Berend J van der; Lagarde, Sjoerd M.; Wijnhoven, Bas P. L.; Valkema, Roelf; Spaander, Manon; Nuyttens, J.; Gaast, Ate van der; Lanschot, J. Jan B. van

doi:10.1016/j.bpg.2018.11.007

Cited by 16 publications

(14 citation statements)

References 54 publications

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“…Of all patients with esophageal cancer worldwide, roughly half live in China. Almost half of the patients present with locally advanced disease and can be curatively treated with neoadjuvant chemoradiotherapy (nCRT) followed by surgery [2]. The CROSS trial showed that after nCRT consisting of carboplatin and paclitaxel with concurrent 41.4 Gy radiotherapy, 23% of patients with adenocarcinoma (AC) and 49% of patients with squamous cell carcinoma (SCC) have a pathologically complete response (pCR) in the resection specimen [3,4].…”

Section: Rationalementioning

confidence: 99%

“…During bite-on-bite biopsy[1][2][3][4] an extra biopsy[3, 4] is taken at the location of the previous biopsy[1,2]. This procedure hypothetically increases the chance of detecting residual submucosal disease compared to conventional biopsies[1,2]. (from: Noordman BJ, Wijnhoven BPL, Lagarde SM, Biermann K, van der Gaast A, Spaander MCW, et al Active surveillance in clinically complete responders after neoadjuvant chemoradiotherapy for esophageal or junctional cancer.…”

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confidence: 99%

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Accuracy of detecting residual disease after neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma (preSINO trial): a prospective multicenter diagnostic cohort study

et al. 2020

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Background: After neoadjuvant chemoradiotherapy (nCRT) for esophageal cancer, high pathologically complete response (pCR) rates are being achieved especially in patients with squamous cell carcinoma (SCC). An active surveillance strategy has been proposed for SCC patients with clinically complete response (cCR) after nCRT. To justify omitting surgical resection, patients with residual disease should be accurately identified. The aim of this study is to assess the accuracy of response evaluations after nCRT based on the preSANO trial, including positron emission tomography with computed tomography (PET-CT), endoscopy with bite-on-bite biopsies and endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) in patients with potentially curable esophageal SCC. Methods: Operable esophageal SCC patients who are planned to undergo nCRT according to the CROSS regimen and are planned to undergo surgery will be recruited from four Asian centers. Four to 6 weeks after completion of nCRT, patients will undergo a first clinical response evaluation (CRE-1) consisting of endoscopy with bite-on-bite biopsies. In patients without histological evidence of residual tumor (i.e. without positive biopsies), surgery will be postponed another 6 weeks. A second clinical response evaluation (CRE-2) will be performed 10-12 weeks after completion of nCRT, consisting of PET-CT, endoscopy with bite-on-bite biopsies and EUS with FNA. Immediately after CRE-2 all patients without evidence of distant metastases will undergo esophagectomy. Results of CRE-1 and CRE-2 as well as results of the three single diagnostic modalities will be correlated to pathological response in the resection specimen (gold standard) for calculation of sensitivity, specificity, negative predictive value and positive predictive value.

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Section: Rationalementioning

confidence: 99%

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confidence: 99%

Accuracy of detecting residual disease after neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma (preSINO trial): a prospective multicenter diagnostic cohort study

et al. 2020

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“…Chemoradiotherapy is the combination of radiotherapy and chemotherapy, which utilizes chemotherapy as a radiosensitizer that renders tumor cells more sensitive to radiotherapy to achieve better local control effect. 1 , 2 In several cases of liver cancer, however, the therapeutic effect of chemoradiotherapy was observed as unexpected, reflected in opposite effect of chemotherapy. Tumor volume rapidly decreased in a short period after patients received a high dose of chemoradiotherapy, but metastasis would occur after discontinuation of chemoradiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Adverse effects of chemoradiotherapy on invasion and metastasis of tumor cells

et al. 2020

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The phenomenon of enhanced invasion and metastasis of residual tumor cells has been observed in an increasing number of patients receiving chemoradiotherapy recently, and tumor metastasis will undoubtedly limit patient prognosis. However, the key mechanism by which chemoradiotherapy affects the invasion and metastasis of tumor cells remains unclear. Studies have shown that chemoradiotherapy may directly act on tumor cells and alter the tumor microenvironment, or induce cell apoptosis and autophagy to promote tumor cell survival and metastasis. In this review, we summarize the potential mechanisms by which chemoradiotherapy may affect the biological behavior of tumor cells and open up new avenues for reducing tumor recurrence and metastasis after treatment. These insights will improve the efficacy of chemoradiotherapy.

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“…Currently, up to one-third of patients show a pathologically complete response after neoadjuvant chemoradiotherapy. To optimise the efficacy of neoadjuvant treatment for individual patients, prediction of response to neoadjuvant treatment is highly desired (Eyck et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Transcriptional factor regulation network and competitive endogenous RNA (ceRNA) network determining response of esophageal squamous cell carcinomas to neoadjuvant chemoradiotherapy

Shao

2019

PeerJ

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Background Neoadjuvant chemoradiotherapy (nCRT) followed by surgery benefits survival for patients with esophageal squamous cell carcinomas (ESCC) compared with surgery alone, but the clinical outcomes of nCRT are heterogeneous. This study aimed to elucidate transcriptional factor (TF) regulation network and competitive endogenous RNA (ceRNA) network determining response of ESCC to nCRT. Materials and Methods RNA microarray data of GSE59974 and GSE45670 were analyzed to investigate the significant changes of lincRNAs, miRNAs, mRNAs in responders and non-responders of nCRT in ESCC. Functional and enrichment analyses were conducted by clusterProfiler. The target lincRNAs and mRNAs of miRNAs were predicted by miRWalk. The ceRNA and TF regulatory networks were constructed using Cytoscape. Results Differentially expressed genes between responders and non-responders mainly enriched in biological process including Wnt signaling pathway and regulation of cell development and morphogenesis involved in differentiation. Besides, these genes showed enrichment in molecular function of glycosaminoglycan binding, metalloendopeptidase inhibitor and growth factor activity. KEGG analysis enriched these genes in pathways of neurotrophin signaling pathway, cell adhesion molecules and Wnt signaling pathway. We also constructed ceRNA network and TF network regulating response of ESCC to nCRT. Core regulatory miRNAs were miR-520a, miR-548am, miR-3184, miR-548d, miR-4725, miR-148a, miR-4659a and key regulatory TFs included MBNL1, SLC26A3, BMP4, ZIC1 and ANKRD7. Conclusion We identified significantly altered lincRNAs, miRNAs and mRNAs involved in the nCRT response of ESCC. In addition, the ceRNA regulatory network of lincRNA-miRNA-mRNA and TF regulatory network were constructed, which would elucidate novel molecular mechanisms determining nCRT response of ESCC, thus providing promising clues for clinical therapy.

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Neoadjuvant chemoradiotherapy for resectable oesophageal cancer

Cited by 16 publications

References 54 publications

Accuracy of detecting residual disease after neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma (preSINO trial): a prospective multicenter diagnostic cohort study

Accuracy of detecting residual disease after neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma (preSINO trial): a prospective multicenter diagnostic cohort study

Adverse effects of chemoradiotherapy on invasion and metastasis of tumor cells

Transcriptional factor regulation network and competitive endogenous RNA (ceRNA) network determining response of esophageal squamous cell carcinomas to neoadjuvant chemoradiotherapy

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