Neoadjuvant DCF May Improve RFS in Advanced Esophageal SCC

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Among patients with esophageal squamous cell carcinoma, neoadjuvant treatment with docetaxel, cisplatin, and fluorouracil improves survival.
Among patients with esophageal squamous cell carcinoma, neoadjuvant treatment with docetaxel, cisplatin, and fluorouracil improves survival.

Among patients with resectable, advanced esophageal squamous cell carcinoma (SCC), neoadjuvant treatment with docetaxel, cisplatin, and fluorouracil (DCF) improves recurrence-free survival (RFS) compared with doxorubicin, cisplatin, and fluorouracil (ACF), according to a study published in the Annals of Oncology.1

The optimal neoadjuvant treatment for patients with esophageal SCC is unclear. Researchers evaluated the efficacy of 2 cisplatin and fluorouracil-based combination regimens on the outcomes of patients with resectable, locally-advanced disease.

For this multicenter, phase 2 trial, investigators enrolled 162 with resectable advanced esophageal SCC and randomly assigned them 1:1 to receive DCF or ACF every 3 weeks. All patients underwent surgery for resection of their tumor after 2 cycles of chemotherapy.

Median follow-up was 34.7 months. The R0 resection rate was 95.9% with ACF versus 96.2% with DCF, though treatment with DCF was associated with a 47% reduction in the risk of recurrence at 2 years as compared with ACF.

The 2-year overall survival rates were 78.6% and 65.4% for DCF and ACF, respectively, which were not significantly different (P = .08).

RELATED: CTA Treatment Regimen Chart for Esophageal and EGJ Cancers Updated

Although there was no difference in overall survival between the 2 treatment arms, the findings suggest that neoadjuvant treatment with DCF may be a promising strategy for resectable esophageal SCC. A larger, phase 3 trial is warranted to compare the efficacy of the current standard treatment, chemoradiotherapy, with DCF chemotherapy.                               

Reference

  1. Yamasaki M, Yasusa T, Yano M, et al. Multicenter randomized phase II study of cisplatin and fluorouracil plus docetaxel (DCF) compared with cisplatin and fluorouracil plus Adriamycin (ACF) as preoperative chemotherapy for resectable esophageal squamous cell carcinoma (OGSG1003). Ann Oncol. 2016 Sep 29. doi: 10.1093/annonc/mdw439 [Epub ahead of print]

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