223PD - Neoadjuvant nimotuzumab plus chemoradiotherapy compared to neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy for locally advanced esophage...

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Gastrointestinal tumours
Topics Cytotoxic agents
Oesophageal Cancer
Surgical oncology
Presenter Xinyu Cheng
Citation Annals of Oncology (2016) 27 (suppl_9): ix68-ix85. 10.1093/annonc/mdw582
Authors X. Cheng1, Y. Chen2, X. Wu1, D. Hao1, Y. Zhang1, X. Li1
  • 1Department Of Radiation Oncology, Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, 450008 - Zhengzhou/CN
  • 2Department Of Digestive Oncology, Renmin Hospital of Wuhan University, 430060 - Wuhan/CN

Abstract

Background

We present the study in which combining neoadjuvant treatment of nimotuzumab with chemoradiotherapy (Bio-nCRT) is compared with neoadjuvant chemoradiotherapy (nCRT) and neoadjuvant chemotherapy (nCT) for patients with potentially resectable locally advanced esophageal cancer.

Methods

The data of patients with stage II-III squamous cell carcinoma of the thoracic esophagus who underwent neoadjuvant therapy and esophagectomy was reviewed. Patients who underwent nCT were treated with two cycles of paclitaxel 175 mg/m2 day 1 and cisplatin 25 mg/m2 days 1-3 of a 3-week cycle. Concomitant radiotherapy (40Gy in 20 fractions, 5 days/week) was added in the nCRT group. Participants in Bio-nCRT group were treated with the same nCRT regimen and the administration of nimotuzumab at a flat dose of 200 mg weekly on week 1-5. Esophagectomy was performed 4-6 weeks after the end of neoadjuvant therapy.

Results

In total, 195 patients received neoadjuvant therapy and 172 (88.2%) completed the entire trimodal therapy. Surgical resection was performed in 94.4% after Bio-nCRT, versus 92.5% after nCRT and 83.5% after nCT (P = 0.026). The R0 resection rate was 100% after Bio-nCRT, 95.9% after nCRT and 92.6% after nCT (P = 0.030). Pathological complete response (pCR) was achieved in 41.2% after Bio-nCRT, versus 32.4% after nCRT and 14.8% after nCT (P = 0.000). Lymph-node metastases were observed in 29.4% in the Bio-nCRT group, versus 21.6% in the nCRT group and 34.6% in the nCT group (P = 0.126; nCRT vs. nCT, P = 0.042).

Conclusions

Comparing to neoadjuvant chemotherapy, neoadjuvant chemoradiotherapy results in higher surgical resection rate, pCR rate and a lower frequency of lymph node metastases. Adding nimotuzumab to neoadjuvant chemoradiotherapy is safe and appears to facilitate complete resection and increase the pCR rate.

Clinical trial indentification

Legal entity responsible for the study

Zhengzhou University

Funding

Zhengzhou University

Disclosure

All authors have declared no conflicts of interest.