Abstract 4546
Background
Half of all patients with esophageal cancer present with advanced disease at diagnosis. The most optimal treatment for this group has not been identified yet. Therefore, we evaluated a weekly regimen of carboplatin for 6 cycles (area under the curve (AUC) of 4) + paclitaxel 100mg/m2 as induction (iCT) or palliative treatment (pCT).
Methods
All patients with advanced (gastro-) esophageal cancer treated with this regimen between 2002-2018 at the Erasmus MC Rotterdam were included. Patients who received radiotherapy or were treated elsewhere were excluded. Data on toxicity, response, and survival were collected from patient records. Analyses were performed in 2 groups: iCT or pCT. Median progression free survival (PFS) and median overall survival (OS) were estimated with the Kaplan-Meier method.
Results
A total of 291 patients was included (iCT:122; pCT:169). Most patients had T3 carcinoma (iCT:54%; pCT:66%), and stage IV disease (iCT:42%; pCT:91%). The majority of the tumors were adenocarcinomas (iCT:50%; pCT:70%) and located at the distal esophagus (iCT:47%; pCT:73%). Incidence of severe grade ≥3 gastrointestinal toxicity was low (iCT:3%; pCT:5%). Grade ≥3 toxicity occurred mainly as hematological toxicity (iCT:71%; pCT:73%) with grade ≥3 neutropenia of 43% and grade 4 of 25% in both groups. Nonetheless, only 3% of patients experienced febrile neutropenia. Premature termination of the planned cycles due to toxicity occurred in 12% of the iCT group and 17% of the pCT group. Cycle delay due to toxicity occurred in 42% (iCT) and 43% (pCT) of the patients. Sensory neuropathy was low-graded and seen in 25% (iCT) and 26% (pCT) of the patients. Overall response rates were 48% (iCT) and 44% (pCT). Esophagectomy or definitive chemoradiotherapy followed in 42% of iCT, resulting in a PFS of 22.1 months (interquartile range (IQR): 12.4-114.2) and OS of 26.8 months (IQR: 15.4-91.7). For pCT, PFS was 8.2 months (IQR: 5.1-14.5) and OS 10.9 months (IQR: 6.5-18.3).
Conclusions
Weekly carboplatin (AUC4) and paclitaxel (100mg/m2) as an outpatient regimen is well-tolerated and an effective induction or palliative treatment regimen for patients with locally advanced or metastatic disease.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
A.H.J. Mathijssen.
Funding
Has not received any funding.
Disclosure
R.H.J. Mathijssen: Research grant / Funding (institution): Astellas; Research grant / Funding (institution): Bayer; Research grant / Funding (institution): Boehringer; Research grant / Funding (institution): Cristal Therapeutics; Research grant / Funding (institution): Novartis; Research grant / Funding (institution): Pamgene; Research grant / Funding (institution): Pfizer; Research grant / Funding (institution): Roche; Research grant / Funding (institution): Sanofi; Honoraria (institution): Servier; Honoraria (institution): Novartis; Travel / Accommodation / Expenses: Pfizer; Travel / Accommodation / Expenses: Astellas. All other authors have declared no conflicts of interest.
Resources from the same session
5203 - Novel fusion genes identified from matched primary and recurred breast cancers by RNA-sequencing
Presenter: Soojeong Choi
Session: Poster Display session 2
Resources:
Abstract
5873 - Association between PIK3CA mutation status and development of brain metastases in HR+/HER2- metastatic breast cancer
Presenter: Donna Fitzgerald
Session: Poster Display session 2
Resources:
Abstract
3588 - The role of AXL as mechanism of resistance to trastuzumab and a prognostic factor in breast cancer HER2 positive: a translational approach.
Presenter: Anna Adam-Artigues
Session: Poster Display session 2
Resources:
Abstract
5640 - Untargeted assessment of tumor fractions in plasma for monitoring and prognostication from metastatic breast cancer patients undergoing systemic treatment
Presenter: Marija Balic
Session: Poster Display session 2
Resources:
Abstract
2616 - Clinical application of mutational analysis in breast cancer patients: the relevance of PIK3CA analysis for precision medicine.
Presenter: Juan Miguel Cejalvo
Session: Poster Display session 2
Resources:
Abstract
3870 - A retrospective gene expression analysis of surgically-removed Breast Cancer Brain Metastasis (BCBM)
Presenter: Meritxell Mallafré-Larrosa
Session: Poster Display session 2
Resources:
Abstract
1240 - Endocrine therapy alone versus targeted combination strategy as first line treatment in elderly patients with hormone receptor-positive advanced breast cancer: meta-analysis of Phase II and III randomized clinical trials
Presenter: Claudia Omarini
Session: Poster Display session 2
Resources:
Abstract
5535 - Alpelisib (ALP) + fulvestrant (FUL) for patients with hormone receptor–positive (HR+), HER2− advanced breast cancer (ABC): management and time course of key adverse events of special interest (AESIs) in SOLAR-1
Presenter: Hope Rugo
Session: Poster Display session 2
Resources:
Abstract
3093 - Changes in Hormone-Receptor status in Luminal breast cancers between primary tumor and metastases: results of the observational cohort GIM-13 AMBRA Study
Presenter: Marina Cazzaniga
Session: Poster Display session 2
Resources:
Abstract
1378 - MONARCH 3: Updated time to chemotherapy and disease progression following abemaciclib plus aromatase inhibitor (AI) in HR+, HER2- advanced breast cancer (ABC)
Presenter: Miguel Martín
Session: Poster Display session 2
Resources:
Abstract