The quality of life in neoadjuvant versus adjuvant therapy of esophageal cancer treatment trial (<scp>QUINTETT</scp>): Randomized parallel clinical superiority trial

Malthaner, Richard; Yu, Edward; Sanatani, Michael; Lewis, Debra; Warner, Andrew; Dar, A. Rashid; Yaremko, Brian; Bierer, Joel; Palma, David A.; Fortin, Dalilah; Inculet, Richard; Fréchette, Éric; Raphael, Jacques; Gaede, Stewart; Kuruvilla, Sara; Younus, Jawaid; Vincent, Mark; Rodrigues, George

doi:10.1111/1759-7714.14433

Cited by 3 publications

(5 citation statements)

References 46 publications

(97 reference statements)

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“…Ninety-six patients were randomized in QUINTETT, 47 patients to Neoadjuvant arm and 49 patients to Adjuvant arm. Patient characteristics are summarized and results from QUINTETT based on all 96 enrolled patients have been reported previously [22]. For the secondary correlative analysis of CTCs, 74 (77.1%) patients had CTC data available and were included in this analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Per QUINTETT trial [22] patients were stratified by clinical nodal status (N0 vs. N1) and by surgeon and then randomized 1:1 to either Neoadjuvant treatment arm (control) or Adjuvant treatment arm (intervention). Randomization occurred centrally through the…”

Section: Randomizationmentioning

confidence: 99%

“…As described in detail in the QUINTETT trial [22], in brief, transhiatal esophagectomy was performed for lower third lesions. Our current standard is a minimally invasive approach (video-assisted thoracoscopic surgery [VATS] and/or laparoscopic) as per tumor location and/ or surgeon preference.…”

Section: Surgery Chemotherapy and Radiation Therapymentioning

confidence: 99%

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Circulating tumor cells detected in follow-up predict survival outcomes in tri-modality management of advanced non-metastatic esophageal cancer: a secondary analysis of the QUINTETT randomized trial

Allan²,

Sanatani³

et al. 2022

BMC Cancer

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Background Our aim was to establish if presence of circulating tumor cells (CTCs) predicted worse outcome in patients with non-metastatic esophageal cancer undergoing tri-modality therapy. Methods We prospectively collected CTC data from patients with operable non-metastatic esophageal cancer from April 2009 to November 2016 enrolled in our QUINTETT esophageal cancer randomized trial (NCT00907543). Patients were randomized to receive either neoadjuvant cisplatin and 5-fluorouracil (5-FU) plus radiotherapy followed by surgical resection (Neoadjuvant) or adjuvant cisplatin, 5-FU, and epirubicin chemotherapy with concurrent extended volume radiotherapy following surgical resection (Adjuvant). CTCs were identified with the CellSearch® system before the initiation of any treatment (surgery or chemoradiotherapy) as well as at 6-, 12-, and 24-months post-treatment. The threshold for CTC positivity was one and the findings were correlated with patient prognosis. Results CTC data were available for 74 of 96 patients and identified in 27 patients (36.5%) at a median follow-up of 13.1months (interquartile range:6.8-24.1 months). Detection of CTCs at any follow-up visit was significantly predictive of worse disease-free survival (DFS;hazard ratio [HR]: 2.44; 95% confidence interval [CI]: 1.41-4.24; p=0.002), regional control (HR: 6.18; 95% CI: 1.18-32.35; p=0.031), distant control (HR: 2.93; 95% CI: 1.52-5.65;p=0.001) and overall survival (OS;HR: 2.02; 95% CI: 1.16-3.51; p=0.013). After adjusting for receiving neoadjuvant vs. adjuvant chemoradiotherapy, the presence of CTCs at any follow-up visit remained significantly predictive of worse OS ([HR]:2.02;95% [Cl]:1.16-3.51; p=0.013) and DFS (HR: 2.49;95% Cl: 1.43-4.33; p=0.001). Similarly, any observed increase in CTCs was significantly predictive of worse OS (HR: 3.14; 95% CI: 1.56-6.34; p=0.001) and DFS (HR: 3.34; 95% CI: 1.67-6.69; p<0.001). Conclusion The presence of CTCs in patients during follow-up after tri-modality therapy was associated with significantly poorer DFS and OS regardless of timing of chemoradiotherapy.

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Section: Resultsmentioning

confidence: 99%

Section: Randomizationmentioning

confidence: 99%

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Circulating tumor cells detected in follow-up predict survival outcomes in tri-modality management of advanced non-metastatic esophageal cancer: a secondary analysis of the QUINTETT randomized trial

Allan²,

Sanatani³

et al. 2022

BMC Cancer

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“…In accordance with national and international clinical guidelines, neoadjuvant chemoradiotherapy (nCRT) is recommended as an option to improve treatment outcomes of thoracic esophageal squamous cell carcinoma (TESCC). As this modality improves survival, it has been reviewed in many recently published papers [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, neoadjuvant CRT is expected to be a more or less aggressive regimen. Many authors reported different types and grades of toxicity [4,6,8]. Moreover, some tumors progress during neoadjuvant treatment.…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant chemoradiotherapy for thoracic esophageal squamous cell carcinoma: does everyone need it?

Chichevatov,

Sinev,

Glukhov

et al. 2024

Sib. onkol. ž.

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Objective. In accordance with clinical guidelines, neoadjuvant chemoradiotherapy (nCRT) is recommended as a beneficial option for treatment of thoracic esophageal squamous cell carcinoma (TESCC). However, some studies did not demonstrate potential benefits of nCRT. In this paper we compared treatment outcomes of surgery alone with preoperative CRT followed by surgery. Material and methods. Group 1 (n=147) consisted of patients who underwent surgery alone. Group 2 (n=3,337) was formed in the framework of the present systematic review and meta-analysis (15 publications captured 20 separate subgroups for analysis). Patients of group 2 received nCRT followed by esophagectomy. Overall survival (OS) and median OS were estimated. Results. The median OS was reached in group 1 and in 12 separate subgroups of group 2 (2310 of 3337 patients). In groups 1 and 2 the OS median estimates were 31.0 and 28.1, respectively (p=0.873). Respective 3-year and 5-year OS were 0.49 vs 0.48 (p=0.425) and 0.37 vs 0.41 (p=0.228). The median OS was not reached in 8 separate subgroups of group 2 (1027 of 3337 patients). In this case, group 2 patients had significantly higher 3- and 5-year OS compared to group 1 patients: 0.69 vs 0.49 (p=0.000) and 0.60 vs 0.37 (p=0.000), respectively. Pathological complete response to nCRT was associated with better survival. conclusion. nCRT is not appropriate for all patients with TESCC. Improved overall survival may be achieved in patients with a high grade of pathological tumor response to neoadjuvant treatment. Selective administration of nCRT based on highly probable prediction of complete tumor response seems promising. This concept needs further research.

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The quality of life in neoadjuvant versus adjuvant therapy of esophageal cancer treatment trial (QUINTETT): Randomized parallel clinical superiority trial

Malthaner

Sanatani

et al. 2022

Thoracic Cancer

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The quality of life in neoadjuvant versus adjuvant therapy of esophageal cancer treatment trial (QUINTETT): Randomized parallel clinical superiority trial

Abstract: The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. There are no other potential conflicts of interest relevant to this article.

Cited by 3 publications

References 46 publications

Circulating tumor cells detected in follow-up predict survival outcomes in tri-modality management of advanced non-metastatic esophageal cancer: a secondary analysis of the QUINTETT randomized trial

Circulating tumor cells detected in follow-up predict survival outcomes in tri-modality management of advanced non-metastatic esophageal cancer: a secondary analysis of the QUINTETT randomized trial

Neoadjuvant chemoradiotherapy for thoracic esophageal squamous cell carcinoma: does everyone need it?

The quality of life in neoadjuvant versus adjuvant therapy of esophageal cancer treatment trial (QUINTETT): Randomized parallel clinical superiority trial

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