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dc.contributor.authorLeichman, Lawrence P.
dc.contributor.authorGoldman, Bryan H.
dc.contributor.authorBohanes, Pierre O.
dc.contributor.authorLenz, Heinz J.
dc.contributor.authorThomas, Charles R.
dc.contributor.authorBillingsley, Kevin G.
dc.contributor.authorCorless, Christopher L.
dc.contributor.authorIqbal, Syma
dc.contributor.authorGold, Philip J.
dc.contributor.authorBenedetti, Jacqueline K.
dc.contributor.authorDanenberg, Kathleen D.
dc.contributor.authorBlanke, Charles D.
dc.date2022-08-11T08:10:32.000
dc.date.accessioned2022-08-23T17:12:20Z
dc.date.available2022-08-23T17:12:20Z
dc.date.issued2011-12-01
dc.date.submitted2017-04-19
dc.identifier.citationJ Clin Oncol. 2011 Dec 1;29(34):4555-60. doi: 10.1200/JCO.2011.36.7490. Epub 2011 Oct 24. <a href="https://doi.org/10.1200/JCO.2011.36.7490">Link to article on publisher's site</a>
dc.identifier.issn0732-183X (Linking)
dc.identifier.doi10.1200/JCO.2011.36.7490
dc.identifier.pmid22025151
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46479
dc.description.abstractPURPOSE: Pathologic complete response (pCR) after neoadjuvant therapy for locally advanced esophageal adenocarcinoma is associated with improved survival. The Southwest Oncology Group designed a trimodality, phase II, single-arm trial with objectives of achieving a pCR rate of 40% with prospective exploratory analyses of intratumoral molecular markers postulated to affect response and survival. PATIENTS AND METHODS: Patients with clinically staged II or III esophageal adenocarcinoma received oxaliplatin 85 mg/m(2) on days 1, 15, and 29; protracted-infusion fluorouracil (PI-FU) 180 mg/m(2)/d on days 8 through 43; and external-beam radiation therapy (EBRT) 5 days a week at 1.8 Gy/d for 25 fractions; surgery was performed 28 to 42 days after neoadjuvant therapy. Chemotherapy was planned after surgery. Tumors were analyzed for mRNA expression and polymorphisms in genes involved in drug metabolism and DNA repair. RESULTS: Ninety-three patients were evaluable. Two deaths (2.2%) were attributable to preoperative therapy, and two deaths (2.2%) were attributable to surgery. Grade 3 and 4 toxicities were recorded for 47.3% and 19.4% of patients, respectively. Seventy-nine patients (84.9%) underwent surgery; 67.7% of patients had R0 resections. Twenty-six patients (28.0%) had confirmed pCR (95% CI, 19.1% to 38.2%). At a median follow-up of 39.2 months, estimates of median and 3-year overall survival (OS) were 28.3 months and 45.1%, respectively. Intratumoral ERCC-1 gene expression was inversely related to progression-free survival and OS. CONCLUSION: Neoadjuvant oxaliplatin, PI-FU, and EBRT for esophageal adenocarcinoma is active and tolerable. Because the regimen failed to meet the primary end point, it does not define a new standard. However, future trials can be built on this platform to validate the role of ERCC-1 in determining the best systemic regimen for individual patients.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22025151&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236655/
dc.subjectHealth Services Administration
dc.subjectNeoplasms
dc.subjectOncology
dc.subjectRadiology
dc.titleS0356: a phase II clinical and prospective molecular trial with oxaliplatin, fluorouracil, and external-beam radiation therapy before surgery for patients with esophageal adenocarcinoma
dc.typeJournal Article
dc.source.journaltitleJournal of clinical oncology : official journal of the American Society of Clinical Oncology
dc.source.volume29
dc.source.issue34
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qarc/31
dc.identifier.contextkey10042075
html.description.abstract<p>PURPOSE: Pathologic complete response (pCR) after neoadjuvant therapy for locally advanced esophageal adenocarcinoma is associated with improved survival. The Southwest Oncology Group designed a trimodality, phase II, single-arm trial with objectives of achieving a pCR rate of 40% with prospective exploratory analyses of intratumoral molecular markers postulated to affect response and survival.</p> <p>PATIENTS AND METHODS: Patients with clinically staged II or III esophageal adenocarcinoma received oxaliplatin 85 mg/m(2) on days 1, 15, and 29; protracted-infusion fluorouracil (PI-FU) 180 mg/m(2)/d on days 8 through 43; and external-beam radiation therapy (EBRT) 5 days a week at 1.8 Gy/d for 25 fractions; surgery was performed 28 to 42 days after neoadjuvant therapy. Chemotherapy was planned after surgery. Tumors were analyzed for mRNA expression and polymorphisms in genes involved in drug metabolism and DNA repair.</p> <p>RESULTS: Ninety-three patients were evaluable. Two deaths (2.2%) were attributable to preoperative therapy, and two deaths (2.2%) were attributable to surgery. Grade 3 and 4 toxicities were recorded for 47.3% and 19.4% of patients, respectively. Seventy-nine patients (84.9%) underwent surgery; 67.7% of patients had R0 resections. Twenty-six patients (28.0%) had confirmed pCR (95% CI, 19.1% to 38.2%). At a median follow-up of 39.2 months, estimates of median and 3-year overall survival (OS) were 28.3 months and 45.1%, respectively. Intratumoral ERCC-1 gene expression was inversely related to progression-free survival and OS.</p> <p>CONCLUSION: Neoadjuvant oxaliplatin, PI-FU, and EBRT for esophageal adenocarcinoma is active and tolerable. Because the regimen failed to meet the primary end point, it does not define a new standard. However, future trials can be built on this platform to validate the role of ERCC-1 in determining the best systemic regimen for individual patients.</p>
dc.identifier.submissionpathqarc/31
dc.contributor.departmentQuality Assurance Review Center
dc.source.pages4555-60


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