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Several American and European clinical trials have yielded mixed results on the survival advantage of preoperative chemoradiotherapy for patients with locally advanced esophagogastric junction adenonocarcinoma. However, a distinguished panel at the 2011 ASTRO Annual Meeting did agree that surgery...
“Fewer than one-third of patients and fewer than 1 in 10 hospitals met the benchmark of examining at least 15 lymph nodes” following esophagectomy for patients with esophageal cancer, according to a retrospective observational study reported in the Archives of Surgery. That benchmark was set by the ...
A phase III study from the United Kingdom has shown that second-line treatment with docetaxel improves overall survival of patients with advanced esophagogastric cancer.1 The strategy has already been widely adopted, but COUGAR-02 is the first study to provide definitive evidence of a survival...
Attendees at the ASCO Annual Meeting are faced with a major challenge of trying to attend as many important sessions as they can over a 4-day period. Our challenge is to feature the major news in The ASCO Post. In addition to our regular comprehensive coverage of key presentations, the following...
Vascular endothelial growth factor (VEGF)– and VEGF receptor-2 (VEGFR-2)–mediated signaling and angiogenesis seem to have an important role in the pathogenesis of gastric cancer. In the phase III REGARD trial reported in Lancet, Charles S. Fuchs, MD, MPH, of Dana-Farber Cancer Institute, Boston,...
More data have emerged that discount the potential for benefit with epidermal growth factor receptor (EGFR) inhibitors in esophageal cancer. The latest comes from the RTOG 0436 randomized phase III trial in patients with nonoperable esophageal cancer, the results of which were presented at the 2014 ...
On April 21, 2014, ramucirumab (Cyramza) was approved for use as a single agent in the treatment of patients with advanced or metastatic gastric or gastroesophageal junction adenocarcinoma with disease progression on or after prior treatment with fluoropyrimidine- or platinum-containing...
Hepatocyte growth factor (HGF) and its receptor MET have been found to promote the proliferation, migration, and survival of tumor cells and to play a role in gastric cancer. In a phase II study reported in The Lancet Oncology, Timothy Iveson, MD, of the University Hospital Southampton NHS...
In a study reported in Clinical Cancer Research, Li and colleagues found that overexpression of Id1 protein resulted in insulin-like growth factor (IGF)-2 production, which, in turn, resulted in esophageal cancer cell proliferation, survival, and invasion via autocrine activation of AKT....
The epidermal growth factor receptor (EGFR) gene is often amplified and its protein overexpressed in upper gastrointestinal cancers—and overexpression has prognostic value. With the advent of monoclonal antibodies and tyrosine kinase inhibitors against EGFR, we have witnessed a rash of randomized...
In what may be the first randomized trial of systemic therapy in this setting, Susan J. Dutton, MSc, of University of Oxford, United Kingdom, and colleagues evaluated the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib vs placebo in patients with esophageal cancer...
TRIM44 family overexpression is associated with carcinogenesis, and TRIM44 has been identified as a prognostic gene. In a study reported in Journal of the National Cancer Institute, Ong and colleagues attempted to identify therapeutic strategies for patients with TRIM44 overexpression. Genomic and...
Researchers at Roswell Park Cancer Institute have been awarded three of four grants by the National Comprehensive Cancer Network (NCCN) Oncology Research Program to evaluate and define the clinical effectiveness of the investigational compound nintedanib. Nintedanib is an investigational...
Radiation therapy alone was found to be as effective as chemoradiation in reducing dysphagia associated with advanced esophageal cancer in the palliative setting and was less toxic, according to results of a multinational phase III trial called the Trans-Tasman Radiation Oncology Group (TROG) 03.01 ...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On November 5, 2014, ramucirumab (Cyramza) was approved for use...
The U.S. Food and Drug Administration (FDA) has approved ramucirumab (Cyramza) for use in combination with paclitaxel for the treatment of patients with advanced gastric or gastroesophageal junction adenocarcinoma. Ramucirumab was approved in April 2014 as a single agent for the treatment of...
A surveillance strategy for patients with esophageal adenocarcinoma treated with chemoradiation and surgery (trimodality therapy) can potentially be customized based on surgical pathology stage, according to an analysis of 518 patients with esophageal adenocarcinoma who underwent trimodality...
“People with a high genetic propensity to obesity have higher risks of esophageal metaplasia and neoplasia than people with a low genetic propensity,” according to analyses of data from the Barrett’s and Esophageal Adenocarcinoma Genetic Susceptibility Study. “These analyses provide the strongest...
Bucking national trends toward preserving the larynx in patients with advanced laryngeal cancer, treatment of patients for stage IV disease at Louisiana State University (LSU) Health-Shreveport were more likely to involve primary surgical therapy, including total laryngectomy, and more likely to...
Palliation of dysphagia associated with advanced esophageal cancer can be effectively accomplished with radiotherapy alone, without the addition of chemotherapy, according to a multinational phase III study presented at the 2015 Gastrointestinal Cancers Symposium.1 “There was no significant...
The MET pathway appears to be important in gastroesophageal cancers, but response to a targeted agent may depend on the class of drugs. A robust response to the novel small-molecule MET inhibitor AMG 337 was observed, but a monoclonal antibody targeting MET fell flat, in studies reported at the...
The information contained in this Clinical Trials Resource Guide includes actively recruiting observational, interventional, phase I, phase II, and phase III clinical studies for patients with newly diagnosed or recurrent esophageal cancer. All of the studies are listed on the National Institutes...
The first inkling I had that something could be seriously wrong occurred just over a year ago, when I was suddenly inflicted with such severe heartburn it kept me awake at night. Prescriptions from my doctor for ranitidine (Zantac) and meloxicam (Mobic) not only failed to tamp down the fiery pain,...
A population-based cohort study “indicates that more extensive lymph node clearance during surgery for esophageal cancer may not improve survival,” Maartje van der Schaaf, MD, PhD, of the Karolinska Institutet, Stockholm, and colleagues reported in the Journal of the National Cancer Institute....
My first experience with cancer was when I was just 9 years old, and a lump the size of an egg popped out on the right side of my neck. A biopsy of the tumor found that it was Hodgkin lymphoma, and I was given huge doses of external-beam radiotherapy applied to my neck, chest, and underarm lymph...
A new study shows that deintensification of chemoradiation therapy translates to excellent pathologic complete response rates in low-risk human papillomavirus (HPV)-associated oropharyngeal cancer.1 Patient-reported outcomes showed that side effects declined after 8 weeks. The hope is that these...
For patients with locally advanced esophageal cancer that has spread to the lymph nodes, radiation therapy that targets only the involved lymph node regions results in less toxicity without causing a statistically significant difference in locoregional lymph node recurrence, distant failure, and...
A small phase Ia clinical trial investigating whether depleting immune cells called Tregs, which can inhibit anticancer immune responses, with KW-0761, a humanized anti-CCR4 monoclonal antibody, in patients with lung or esophageal cancer has found that the therapy dramatically reduced the number of ...
In a retrospective European study reported in the Journal of Clinical Oncology, Markar et al found that salvage esophagectomy after definitive chemoradiotherapy was associated with similar survival outcomes vs neoadjuvant chemotherapy followed by planned esophagectomy in treatment of...
Initial results of the Dutch phase III CROSS trial showed a significant 5-year overall survival benefit with the addition of neoadjuvant chemoradiotherapy to surgery after a median 45-month follow-up in patients with squamous cell carcinoma or adenocarcinoma of the esophagus or esophagogastric...
A “pill on a string” developed by researchers at the University of Cambridge could help doctors detect esophageal cancer at an early stage, helping them overcome the problem of wide variation between biopsies, suggests research published by Ross-Innes et al in Nature Genetics. The...
Interpace Diagnostics, a subsidiary of PDI, Inc, announced new data demonstrating the clinical value of BarreGen, a molecular diagnostic test that predicts the risk of progression from Barrett’s esophagus to esophageal cancer approximately 3 to 4 years before the cancer develops. These...
Long-term, regular aspirin use was associated with a modestly reduced overall risk for cancer, driven primarily by a reduction in the risk for colorectal cancers, according to research presented at the AACR Annual Meeting 2015, held April 18 to 22 in Philadelphia (Abstract 876). “Previous...
A population-based cohort study indicates that “more extensive lymph node clearance during surgery for esophageal cancer may not improve survival,” van der Schaaf et al reported in the Journal of the National Cancer Institute. “These results challenge current clinical guidelines,...
The U.S. Food and Drug Administration (FDA) today approved ramucirumab (Cyramza) for use in combination with paclitaxel for the treatment of patients with advanced gastric or gastroesophageal junction adenocarcinoma. Ramucirumab was approved in April 2014 as a single agent for the treatment of...
In a study reported in the Journal of Clinical Oncology, Sudo et al found that many patients undergoing definitive chemoradiotherapy (bimodality therapy) for esophageal cancer can derive substantial survival benefit from subsequent salvage surgery, supporting a practice of intensive...
Elevated esophageal mucosa cyclooxygenase-2 (COX-2) levels appear to be associated with the presence of Barrett’s esophagus as well as high waist-to-hip ratios and current tobacco smoking, according to the results of a study reported by Nguyen et al in Digestive Diseases & Sciences. These ...
Serum levels of VEGF-A and TGF-β1 may be helpful in tailoring neoadjuvant treatment regimens for patients with esophageal squamous cell carcinoma, according to research presented at the American Society for Radiation Oncology’s (ASTRO) 56th Annual Meeting (Abstract 10). Results of...
Radiation therapy alone is as effective in decreasing swallowing complications experienced by advanced esophageal cancer patients as radiation therapy combined with chemotherapy, thus allowing patients to forgo chemotherapy, according to research presented at the American Society for Radiation...
In a European analysis reported in the Journal of Clinical Oncology, Davies et al found that pathologic tumor downstaging after neoadjuvant chemotherapy was the strongest independent predictor of overall survival in patients undergoing surgery for esophageal and esophagogastric junction...
A new study published in the Journal of the National Cancer Institute by researchers at Northwestern Medicine shed new light on the risks associated with the growing popularity of endoscopic resection in the treatment of localized, early-stage esophageal cancer. Merkow et al found that the...
Statin use was associated with a significantly reduced risk of developing Barrett’s esophagus, according to a new study by Nguyen et al in Gastroenterology. Obese patients experienced the greatest level of risk reduction with statin use. While statins have been associated with a reduced risk...
The effect of neoadjuvant chemoradiation therapy in early-stage esophageal cancer is not clear. In the phase III FFCD 9901 trial reported in the Journal of Clinical Oncology, Mariette et al found that neoadjuvant chemoradiation including fluorouracil (5-FU) and cisplatin did not improve R0...
Hepatocyte growth factor (HGF) and its receptor MET have been found to promote the proliferation, migration, and survival of tumor cells and to play a role in gastric cancer. In a phase II study reported in The Lancet Oncology, Iveson et al found evidence of benefit from adding the anti-HGF...
In what may be the first randomized trial of systemic therapy in this setting, Dutton and colleagues evaluated gefitinib (Iressa) vs placebo in patients with esophageal cancer progressing after chemotherapy. As reported in The Lancet Oncology, the COG trial showed no survival benefit with gefitinib ...
In a single-blind phase III trial reported in The Lancet Oncology, Zhu et al compared the use of 125iodine seed–loaded vs conventional covered stents along with single high-dose brachytherapy as palliative treatment in patients with unresectable esophageal cancer. Use of the irradiated stents ...
Barrett’s esophagus with low-grade dysplasia increases risk of esophageal adenocarcinoma. In a European study reported in JAMA, Phoa et al assessed whether endoscopic radiofrequency ablation reduced the rate of neoplastic progression compared with endoscopic surveillance in patients with...
Patients with the most common type of esophageal cancer are less likely to respond to chemotherapy when their tumors are high in a protein called leptin, according to a study by Bain et al published in the British Journal of Cancer. Study Details Researchers from the University of Aberdeen...
More data have emerged that discount the potential for benefit with epidermal growth factor receptor (EGFR) inhibitors in esophageal cancer. The latest comes from the RTOG 0436 randomized phase III trial in patients with nonoperable esophageal cancer, the results of which were presented at the 2014 ...
Use of a minimally invasive endoscopic procedure to remove superficial, early-stage esophageal cancer is as effective as surgery that takes out and rebuilds the esophagus, according to a study by researchers at Mayo Clinic in Florida. The research, published in Clinical Gastroenterology and...