Undervalued Criteria in the Evaluation of Multimodal Trials for Upper GI Cancers

Brücher, Björn L.D.M.; Kitajima, Masaki; Siewert, J. R.

doi:10.3109/07357907.2014.958497

Cited by 2 publications

(3 citation statements)

References 117 publications

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“…Due to the uniqueness of AEG, treatment for this condition has attracted increasing attention from scholars. Most clinicians believe that appropriate perioperative treatments should be used for AEG, and regarding this topic, an increasing number of researchers are trying preoperative concurrent chemoradiotherapy for AEG ( 4 , 5 ). Undoubtedly, the Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study (CROSS) trial ( 6 ) is a milestone of preoperative concurrent chemoradiotherapy on AEG, but it still has some deficiencies, such as the inclusion of patients not only with AEG but also with lower esophageal cancer and squamous cell carcinoma and the inclusion of patients mostly in the early and middle stages.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Efficacy of Neoadjuvant Concurrent Chemoradiotherapy for Potentially Resectable Advanced Siewert Type II and III Adenocarcinomas of the Esophagogastric Junction

et al. 2021

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BackgroundReports have shown that neoadjuvant concurrent chemoradiotherapy (nCRT) increases the R0 resection rate for patients with Siewert type II or III adenocarcinoma of the gastroesophageal junction (AEG). However, the long-term efficacy of nCRT for AEG patients remains unclear. In this multicenter study, we investigated the long-term results of AEG patients treated with nCRT.MethodsA total of 149 patients with potentially resectable advanced AEG (T3/4, Nany, M0) were randomly divided into two groups: the nCRT-treated group (treated group) (n = 76) and the surgery group (control group) (n = 73). The primary endpoint was disease-free survival (DFS), and the secondary outcome indexes included the R0 resection rate, HER-2 expression, tumor regression grade (TRG), objective response rate (ORR), disease control rate (DCR), overall survival (OS), and adverse events.ResultsIn the treated group, the overall therapeutic efficacy rate was 40.8%, and the pathological complete response (pCR) rate was 16.9%. The rates of patients who underwent R0 resection in the treated and control groups were 97.0% and 87.7%, respectively (p < 0.05). The toxic effects were mainly graded 1–2 in the treated group. The median DFS times in the treated and control groups were 33 and 27 months, respectively (p = 0.08), whereas the median OS times were 39 and 30 months, respectively (p = 0.01). The median DFS times of patients with positive and negative HER-2 expression in the treated group were 13 and 43 months, respectively (p = 0.01), and the median OS times were 27 and 41 months, respectively (p = 0.01).ConclusionSurgery after nCRT improved the efficacy of treatment for AEG patients and thus provided a better prognosis.Clinical Trial RegistrationThe trial is registered with ClinicalTrials.gov (number NCT01962246).

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Section: Introductionmentioning

confidence: 99%

Long-Term Efficacy of Neoadjuvant Concurrent Chemoradiotherapy for Potentially Resectable Advanced Siewert Type II and III Adenocarcinomas of the Esophagogastric Junction

et al. 2021

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“…Different tumor entities with different tumor biologies, prognoses, and different therapeutic approaches make it difficult to make informed recommendations. As pointed out, many hitherto undervalued criteria such as epidemiology, embryology, and molecular biology will be important to consider when designing future research and clinical trials [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite many variables [ 4 ] epidemiologic observations are of value. Since the identification of Helicobacter pylori (H. pylori) , the incidences in gastric cancers have decreased worldwide, but there are reports of increases in esophageal squamous cell carcinomas (ESCC) as well as of adenocarcinomas of the esophago-gastral junction [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Genomics, microRNA, epigenetics, and proteomics for future diagnosis, treatment and monitoring response in upper GI cancers

Brücher

Schnabel³

et al. 2016

Clinical & Translational Med

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One major objective for our evolving understanding in the treatment of cancers will be to address how a combination of diagnosis and treatment strategies can be used to integrate patient and tumor variables with an outcome-oriented approach. Such an approach, in a multimodal therapy setting, could identify those patients (1) who should undergo a defined treatment (personalized therapy) (2) in whom modifications of the multimodal therapy due to observed responses might lead to an improvement of the response and/or prognosis (individualized therapy), (3) who might not benefit from a particular toxic treatment regimen, and (4) who could be identified early on and thereby be spared the morbidity associated with such treatments. These strategies could lead in the direction of precision medicine and there is hope of integrating translational molecular data to improve cancer classifications. In order to achieve these goals, it is necessary to understand the key issues in different aspects of biotechnology to anticipate future directions of personalized and individualized diagnosis and multimodal treatment strategies. Providing an overview of translational data in cancers proved to be a challenge as different methods and techniques used to obtain molecular data are used and studies are based on different tumor entities with different tumor biology and prognoses as well as vastly different therapeutic approaches. The pros and cons of the available methodologies and the potential response data in genomics, microRNA, epigenetics and proteomics with a focus on upper gastrointestinal cancers are considered herein to allow for an understanding of where these technologies stand with respect to cancer diagnosis, prognosis and treatment.

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Undervalued Criteria in the Evaluation of Multimodal Trials for Upper GI Cancers

Cited by 2 publications

References 117 publications

Long-Term Efficacy of Neoadjuvant Concurrent Chemoradiotherapy for Potentially Resectable Advanced Siewert Type II and III Adenocarcinomas of the Esophagogastric Junction

Long-Term Efficacy of Neoadjuvant Concurrent Chemoradiotherapy for Potentially Resectable Advanced Siewert Type II and III Adenocarcinomas of the Esophagogastric Junction

Genomics, microRNA, epigenetics, and proteomics for future diagnosis, treatment and monitoring response in upper GI cancers

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