Abstract 2860
Background
Although, previous studies reported that metabolic response (MR) assessed by post-CRT 18FDG-PET was associated with survival outcomes in ESCC treated with dCRT, there are few data on the prognostic value of each metabolic response category after induction chemotherapy prior to dCRT and after completion of dCRT.
Methods
In this retrospective study, we evaluated prognostic value of MR after completion of induction chemotherapy and after completion of dCRT in 382 localized ESCC pts receiving induction chemotherapy followed by dCRT from January 2012 to February 2018 at Asan Medical Center in Korea. MR was assessed by EORTC criteria.
Results
MR after induction chemotherapy was significantly associated with progression-free survival (PFS) and overall survival (OS). MR after dCRT was also significantly associated with PFS and OS. MR after either induction chemotherapy or dCRT remained significant after adjusting for other prognostic factors such as clinical TNM stage, sex, and ECOG performance status. Whereas pts achieving mCR/mPR or mPD after either induction chemotherapy or dCRT had good prognosis or poor prognosis, respectively, the prognostic value of mSD was different between post-induction chemotherapy and post-dCRT; it was similar to that of mPR after induction chemotherapy, but it was similar to that of mPD after dCRT. Poorer MR to induction chemotherapy could predict the lack of MR after dCRT; the proportion of mSD/mPD after dCRT was 7.7% in pts with post-induction mCR vs. 16.0% in pts with vs. 40.0% in pts with post-induction mSD vs. 100% in pts with post-induction mPD (p = 0.001).Table:
762P
Post induction chemotherapy | Post-dCRT | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
metabolic response | N | HR for PFS (95% CI) | P-value | HR for OS (95% CI) | P-value | N | HR for PFS (95% CI) | P-value | HR for OS (95% CI) | P-value |
mCR | 13 | 1 | 1 | 150 | 1 | 1 | ||||
mPR | 106 | 3.348 (1.221-9.181) | 0.019 | 2.498 (1.008 - 6.192) | 0.048 | 164 | 2.182 (1.646-2.892) | 0.000 | 2.224 (1.694-2.919) | 0.000 |
mSD | 10 | 6.008 (1.179-20.150) | 0.004 | 3.640 (1.186-11.171) | 0.024 | 7 | 11.251 (5.088-24.878) | 0.000 | 9.659 (4.393-21.236) | 0.000 |
mPD | 2 | 59.209 (9.430-371.767) | 0.000 | 14.495 (2.676-78.503) | 0.002 | 39 | 21.768 (14.020-33.797) | 0.000 | 10.592 (7.016-15.989) | 0.000 |
diffuse esophagitis | 3 | 1.729 (0.193-15.482) | 0.624 | 1.103 (0.129-9.453) | 0.929 | 22 | 1.169 (0.651-2.098) | 0.601 | 1.482 (0.856-2.566) | 0.160 |
Total | 134 | 0.000 | 0.027 | 382 | 0.000 | 0.000 |
Conclusions
MR after induction chemotherapy and after CRT had independent prognostic value with different prognostication between each other in ESCC pts receiving induction chemotherapy followed by dCRT.
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
4413 - Infigratinib versus gemcitabine plus cisplatin multicenter, open-label, randomized, phase 3 study in patients with advanced cholangiocarcinoma with FGFR2 gene fusions/translocations: the PROOF trial
Presenter: Ghassan Abou-Alfa
Session: Poster Display session 2
Resources:
Abstract
4710 - Phase 3 (COSMIC-312) study of cabozantinib (C) in combination with atezolizumab (A) vs sorafenib (S) in patients (pts) with advanced hepatocellular carcinoma (aHCC) who have not received previous systemic anticancer therapy
Presenter: Lorenza Rimassa
Session: Poster Display session 2
Resources:
Abstract
5509 - A Randomized Controlled, Open label, Adaptive Phase-3 Trial to Evaluate Safety and Efficacy of EndoTAG-1 Plus Gemcitabine versus Gemcitabine alone in Patients with Measurable Locally Advanced and/or Metastatic Adenocarcinoma of the Pancreas Failed on FOLFIRINOX Treatment (NCT03126435)
Presenter: Li-Tzong Chen
Session: Poster Display session 2
Resources:
Abstract
1463 - Modified FOLFOX versus modified FOLFOX plus nivolumab and ipilimumab in patients with previously untreated advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction – Moonlight, a randomized phase 2 trial of the German Gastric Group of the AIO.
Presenter: Sylvie Lorenzen
Session: Poster Display session 2
Resources:
Abstract
2392 - GLOW: Randomized Phase 3 Study of Zolbetuximab + CAPOX Compared With Placebo + CAPOX as First-line Treatment of Patients With CLD18.2⁺/HER2⁻ Locally Advanced Unresectable or Metastatic Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma
Presenter: Manish Shah
Session: Poster Display session 2
Resources:
Abstract
5217 - PRODIGE67_UCGI33 ARION: Association of Radiochemotherapy and Immunotherapy for the treatment of unresectable Oesophageal caNcer: a comparative randomized phase II trial
Presenter: Rosine Guimbaud
Session: Poster Display session 2
Resources:
Abstract
1726 - Randomized phase II trial of weekly paclitaxel + ramucirumab versus weekly nab-paclitaxel + ramucirumab for unresectable advanced or recurrent gastric cancer with peritoneal dissemination refractory to first-line therapy: WJOG10617G/P-SELECT
Presenter: Kenro Hirata
Session: Poster Display session 2
Resources:
Abstract
2279 - FRONTiER: A Feasibility Trial of Nivolumab With Neoadjuvant CF or DCF Therapy for Locally Advanced Esophageal Carcinoma
Presenter: Shun Yamamoto
Session: Poster Display session 2
Resources:
Abstract
4912 - A phase Ib/II study of AK104, a PD-1/CTLA-4 Bispecific Antibody, Combined With mXELOX as First-line Therapy for Advanced Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma
Presenter: Jiafu Ji
Session: Poster Display session 2
Resources:
Abstract
3780 - Perioperative atezolizumab in combination with FLOT versus FLOT alone in patients with resectable esophagogastric adenocarcinoma: DANTE, a randomized, open-label phase II trial of the German Gastric Group of the AIO and the SAKK.
Presenter: Salah-Eddin Al-Batran
Session: Poster Display session 2
Resources:
Abstract