Results and Molecular Correlates from a Pilot Study of Neoadjuvant Induction FOLFIRINOX Followed by Chemoradiation and Surgery for Gastroesophageal Adenocarcinomas

Autor:	Emily E. Van Seventer, Jill N. Allen, David P. Ryan, Michael Lanuti, Florence K. Keane, Jeffrey W. Clark, Theodore S. Hong, Ryan B. Corcoran, Mari Mino-Kenudson, Aparna Raj Parikh, Christopher R. Morse, Lorraine C. Drapek, Eric Roeland, Jennifer Y. Wo, Christian V. Baglini, Beow Y. Yeap, Benjamin Christopher, Christine A. Ulysse, Isobel J Fetter, Melin J. Khandekar, Rebecca S. Heist, Heather A. Shahzade, Samuel J. Klempner, Christine E. Eyler, John T. Mullen
Rok vydání:	2021
Předmět:	Cancer Research Treatment response medicine.medical_specialty Intention-to-treat analysis business.industry FOLFIRINOX Locally advanced Carboplatin Surgery chemistry.chemical_compound Oncology Paclitaxel chemistry Cohort Medicine business Prospective cohort study
Zdroj:	Clinical Cancer Research. 27:6343-6353
ISSN:	1557-3265 1078-0432
Popis:	Purpose: We performed a NCI-sponsored, prospective study of neoadjuvant FOLFIRINOX followed by chemoradiation with carboplatin/paclitaxel followed by surgery in patients with locally advanced gastric or gastroesophageal cancer. Patients and Methods: The primary objective was to determine completion rate of neoadjuvant FOLFIRINOX × 8 followed by chemoradiation. Secondary endpoints were toxicity and pathologic complete response (pCR) rate. Exploratory analysis was performed of circulating tumor DNA (ctDNA) to treatment response. Results: From October 2017 to June 2018, 25 patients were enrolled. All patients started FOLFIRINOX, 92% completed all eight planned cycles, and 88% completed chemoradiation. Twenty (80%) patients underwent surgical resection, and 7 had a pCR (35% in resected cohort, 28% intention to treat). Tumor-specific mutations were identified in 21 (84%) patients, of whom 4 and 17 patients had undetectable and detectable ctDNA at baseline, respectively. Presence of detectable post-chemoradiation ctDNA (P = 0.004) and/or postoperative ctDNA (P = 0.045) were associated with disease recurrence. Conclusions: Here we show neoadjuvant FOLFIRINOX followed by chemoradiation for locally advanced gastroesophageal cancer is feasible and yields a high rate of pCR. ctDNA appears to be a promising predictor of postoperative recurrence. See related commentary by Catenacci, p. 6281
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::00c709ab50a4de285b3308fa15814835 https://doi.org/10.1158/1078-0432.ccr-21-0331 Zobrazit plný text záznamu