Abstract 2403
Background
For patients (pts) with esophageal (ES) cancer and fragility or limiting comorbidities resulting in contraindications for surgery, CRT is the only treatment option with curative potential. In this scenario, the best evidence is CRT followed by consolidation chemotherapy based on fluoropyrimidine/platin combination (RTOG 98-01/PRODIGE 5). However, definitive CRT with CP is frequently used due to better tolerance and convenience, despite the lack of phase III trials.
Methods
Consecutive frail/comorbid pts with ES cancer were retrospectively selected. Primary objective was to compare response rate (RR) by RECIST 1.1, disease-free survival (DFS) and overall survival (OS) between CRT followed by consolidation with 2 cycles of CF and definitive CRT with weekly CP (carboplatin AUC 2 and paclitaxel 50mg/m2). Radiotherapy dose: 50,4 Gy. Secondary objectives: prognostic factors and safety. Descriptive statistics were used for population characteristics analysis and Kaplan-Meier curves, Log-Rank Test and Cox Regression for survival analysis.
Results
From May, 2010 to May, 2018, 99 pts were treated, 18 (18.2%) with CF and 81 (81.8%) with CP. Median follow-up was 38.7 months (m). 48 (48.5%) were alive at the cut-off date. Median age at diagnosis was 65 (32-86). 72.7% were men. 86.9% had squamous cell carcinoma; 42.4% stage II and 49.5% III. Localization: thoracic (53.3%), abdominal (20.1%), cervical (15.2%) and EGJ (10.1%). General characteristics were well balanced between groups. RR after the CRT phase were similar (CP: 53.1%; CF: 55.5%; p = 0.198). Median DFS was 23.2m (95%CI 5.9-not reached) and 7.2m (95%CI 4.9-9.4) for CF and CP, respectively (HR 0.55; 95%CI 0.29-1.56; p = 0.08). In the multivariate analysis CF was an independent prognostic factor for improved OS (HR 0.36; 95%CI 0.15-0.91; p = 0.03), as were higher body mass index (p = 0.03) and staging (p = 0.04). Rates of major toxicities were similar between the groups.
Conclusions
CRT followed by consolidation with CF seems to offer better outcomes than definitive CRT with CP for ES cancer pts not eligible for surgery. Consolidation therapy or type of chemotherapy may have contributed for this difference in outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2107 - Role of Individualized Intervention(s) on Quality of Life (QOL) and Adherence to Adjuvant Endocrine Therapy in Premenopausal Women with Early-Stage Breast Cancer (BC): MyChoice Study
Presenter: Shahid Ahmed
Session: Poster Display session 2
Resources:
Abstract
5812 - Correlation between the density of tumor-infiltrating lymphocytes, immune cell subsets in tumor stroma and response to systemic therapy in breast cancer
Presenter: Cvetka Grasic Kuhar
Session: Poster Display session 2
Resources:
Abstract
4734 - BRCA1/2 Testing in HER2- Advanced Breast Cancer (ABC): Results from the European Component of a Multi-Country Real World Study
Presenter: Michael Patrick Lux
Session: Poster Display session 2
Resources:
Abstract
1686 - In vitro and in vivo rescue of resistance to BET inhibitors by targeting PLK1 in triple negative breast cancer.
Presenter: Cristina Nieto-jiménez
Session: Poster Display session 2
Resources:
Abstract
5020 - Neoadjuvant endocrine therapy in combination with melatonin and metformin in locally advanced breast cancer
Presenter: Tatiana Semiglazova
Session: Poster Display session 2
Resources:
Abstract
5082 - Melatonin and metformin in neoadjuvant chemotherapy in locally advanced breast cancer
Presenter: Tatiana Semiglazova
Session: Poster Display session 2
Resources:
Abstract
2642 - Patient-tailored tamoxifen dosing based on an increased quantitative understanding of its complex pharmacokinetics: A novel integrative modelling approach
Presenter: Anna Mueller-Schoell
Session: Poster Display session 2
Resources:
Abstract
2461 - Lack of benefit of neoadjuvant pertuzumab in high risk HER2 positive breast cancer. A retrospective case-control study of 355 cases with biomarker analysis.
Presenter: Manuela Tiako Meyo
Session: Poster Display session 2
Resources:
Abstract
4776 - Targeting CDCA3 to improve chemotherapy response in triple-negative breast cancer patients
Presenter: Kenneth O'Byrne
Session: Poster Display session 2
Resources:
Abstract
1674 - Activity of BET-proteolysis targeting chimeric (PROTAC) compounds in triple negative breast cancer
Presenter: María Del Mar Noblejas López
Session: Poster Display session 2
Resources:
Abstract