Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan
Junya Kitadani , Masaki Nakamura , Toshiyasu Ojima , Masahiro Katsuda , Keiji Hayata , Hiroki Yamaue
Background: The current standard treatment for clinical stage II/III esophageal cancer is neoadjuvant chemotherapy (NAC) with CDDP/5-FU (CF) regimen followed by surgery. However, to improve the survival of patients with advanced ESCC, more effective regimens are urgently needed. Triplet regimens containing docetaxel have been one of next candidates for advanced ESCC. Methods: The DCS regimen (Docetaxel 40mg/m2/day Day 1 div, CDDP 60mg/m2/day Day 1 div, S-1 80mg/m2/day Day 1~14 civ) was repeated every 4weeks until toxicity became unacceptable, the patient refused treatment, or disease progression was observed to a maximum of 3cycles. In this phase II trial of DCS, the primary endpoint was pathological response rate. Results: 40 patients were enrolled in this study and finally 39 patients underwent surgery and one patient performed chemoradiotherapy because of patient refusal. cT3 was 85%, cStage III and IV were 90%. Far advanced cases were in this study. Surgical complication was not increased compared to the historical data. R0 resection rate was achieved in 85%. The clinical response rate was 76%. Pathological response rate was 33%, which was the primary endpoint. 2-year recurrence-free survival rate was 56% and 2-year overall survival rate was 71%. The rate of Grade 3 or 4 Neutropenia was 69%, and FN was 18%. NAC-DCS was high toxic regimen, but manageable regimen. The median time of onset with Grade 3/4 neutropenia was day 11 from start of each cycle. Conclusions: NAC with DCS regimen was feasible and good response for advanced ESCC and became to a promising candidate. Further, the survival benefit of triplet regimen including S-1 should be verified by the randomized controlled trial. Clinical trial information: UMIN000017153.
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2024 ASCO Annual Meeting
First Author: Hojung An
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Takahiro Tsushima
2023 ASCO Annual Meeting
First Author: Na Zhuo
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Yin Li