Promising outcomes of definitive chemoradiation and cetuximab for patients with esophageal squamous cell carcinoma.

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Promising outcomes of definitive chemoradiation and cetuximab for patients with esophageal squamous cell carcinoma.

Cancer Sci. 2012 Jul 27;

Authors: Chen Y, Wu X, Bu S, He C, Wang W, Liu J, Guo W, Tan B, Wang Y, Wang J

Abstract
This study investigated cetuximab added to definitive concurrent chemoradiation for esophageal squamous cell carcinoma (ESCC). Previously untreated patients with stage II-IVa ESCC received cetuximab (400�mg/m(2) /wk in week 1, then�250 mg/m(2) /wk during weeks 2 to 8), paclitaxel (45 mg/m(2) /wk) and cisplatin (20 mg/m(2) /wk) in weeks 2 to 8 with 59.4Gy radiotherapy. EGFR status in tumor specimens was assessed. Thirty-one patients were enrolled and evaluated for toxicity. Of the 29 patients assessable for response, 20 (69.0%) had clinical complete response (CR). Over a median follow-up of 23.6 months, disease progression was observed in 7 patients. The 1- and 2-year progression-free survival (PFS) rates were 85.5% and 75.1%, respectively. PFS was shorter for patients with lymphatic metastatic disease than for those with locally confined tumor, one-year PFS rate was 78.7% and 92.3%, respectively (P = 0.038). Sixteen patients (55.2%) were immunohistochemically positive for EGFR. The patients with EGFR-expressing tumor had a CR rate of 75.0% compared to 61.5% in those�with negative EGFR expression (P = 0.024). The PFS for patients with EGFR-expressing tumor was longer compared with the PFS of patients with negative EGFR (P = 0.133). The patients with prominent cetuximab-induced rash (? grade 2) had better CR rate and PFS than those with no or grade 1 rash (P < 0.05). The rates of Grades 3/4 esophagitis, hematologic and dermatologic toxicities were 9.7%, 29.0% and 16.1%, respectively. The regimen of definitive chemoradiation plus cetuximab achieved good clinical response and has an acceptable safety profile in Chinese ESCC patients.

PMID: 22845557 [PubMed - as supplied by publisher]

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