Neoadjuvant irinotecan, cisplatin, and concurrent radiation therapy with celecoxib for patients with locally advanced esophageal cancer

Persistent Link:
http://hdl.handle.net/10150/618723
Title:
Neoadjuvant irinotecan, cisplatin, and concurrent radiation therapy with celecoxib for patients with locally advanced esophageal cancer
Author:
Cleary, James M.; Mamon, Harvey J.; Szymonifka, Jackie; Bueno, Raphael; Choi, Noah; Donahue, Dean M.; Fidias, Panos M.; Gaissert, Henning A.; Jaklitsch, Michael T.; Kulke, Matthew H.; Lynch, Thomas P.; Mentzer, Steven J.; Meyerhardt, Jeffrey A.; Swanson, Richard S.; Wain, John; Fuchs, Charles S.; Enzinger, Peter C.
Affiliation:
Univ Arizona, Ctr Canc, St Josephs Hosp & Med Ctr
Issue Date:
2016-07-13
Publisher:
BioMed Central
Citation:
Neoadjuvant irinotecan, cisplatin, and concurrent radiation therapy with celecoxib for patients with locally advanced esophageal cancer 2016, 16 (1) BMC Cancer
Journal:
BMC Cancer
Rights:
© 2016 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
Collection Information:
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
Abstract:
Background: Patients with locally advanced esophageal cancer who are treated with trimodality therapy have a high recurrence rate. Preclinical evidence suggests that inhibition of cyclooxygenase 2 (COX2) increases the effectiveness of chemoradiation, and observational studies in humans suggest that COX-2 inhibition may reduce esophageal cancer risk. This trial tested the safety and efficacy of combining a COX2 inhibitor, celecoxib, with neoadjuvant irinotecan/cisplatin chemoradiation. Methods: This single arm phase 2 trial combined irinotecan, cisplatin, and celecoxib with concurrent radiation therapy. Patients with stage IIA-IVA esophageal cancer received weekly cisplatin 30 mg/m(2) plus irinotecan 65 mg/m(2) on weeks 1, 2, 4, and 5 concurrently with 5040 cGy of radiation therapy. Celecoxib 400 mg was taken orally twice daily during chemoradiation, up to 1 week before surgery, and for 6 months following surgery. Results: Forty patients were enrolled with stage IIa (30 %), stage IIb (20 %), stage III (22.5 %), and stage IVA (27.5 %) esophageal or gastroesophageal junction cancer (AJCC, 5th Edition). During chemoradiation, grade 3-4 treatment-related toxicity included dysphagia (20 %), anorexia (17.5 %), dehydration (17.5 %), nausea (15 %), neutropenia (12.5 %), diarrhea (10 %), fatigue (7.5 %), and febrile neutropenia (7.5 %). The pathological complete response rate was 32.5 %. The median progression free survival was 15.7 months and the median overall survival was 34.7 months. 15 % (n = 6) of patients treated on this study developed brain metastases. Conclusions: The addition of celecoxib to neoadjuvant cisplatin-irinotecan chemoradiation was tolerable; however, overall survival appeared comparable to prior studies using neoadjuvant cisplatin-irinotecan chemoradiation alone. Further studies adding celecoxib to neoadjuvant chemoradiation in esophageal cancer are not warranted.
Note:
Open Access Journal
ISSN:
1471-2407
PubMed ID:
27412386
DOI:
10.1186/s12885-016-2485-9
Keywords:
Esophageal cancer; Neoadjuvant therapy; Chemoradiation; Cyclooxygenase 2 inhibition
Version:
Final published version
Sponsors:
National Institute of Health [P50CA127003]; Pharmacia Oncology
Additional Links:
http://bmccancer.biomedcentral.com/articles/10.1186/s12885-016-2485-9

Full metadata record

DC FieldValue Language
dc.contributor.authorCleary, James M.en
dc.contributor.authorMamon, Harvey J.en
dc.contributor.authorSzymonifka, Jackieen
dc.contributor.authorBueno, Raphaelen
dc.contributor.authorChoi, Noahen
dc.contributor.authorDonahue, Dean M.en
dc.contributor.authorFidias, Panos M.en
dc.contributor.authorGaissert, Henning A.en
dc.contributor.authorJaklitsch, Michael T.en
dc.contributor.authorKulke, Matthew H.en
dc.contributor.authorLynch, Thomas P.en
dc.contributor.authorMentzer, Steven J.en
dc.contributor.authorMeyerhardt, Jeffrey A.en
dc.contributor.authorSwanson, Richard S.en
dc.contributor.authorWain, Johnen
dc.contributor.authorFuchs, Charles S.en
dc.contributor.authorEnzinger, Peter C.en
dc.date.accessioned2016-08-24T01:19:45Z-
dc.date.available2016-08-24T01:19:45Z-
dc.date.issued2016-07-13-
dc.identifier.citationNeoadjuvant irinotecan, cisplatin, and concurrent radiation therapy with celecoxib for patients with locally advanced esophageal cancer 2016, 16 (1) BMC Canceren
dc.identifier.issn1471-2407-
dc.identifier.pmid27412386-
dc.identifier.doi10.1186/s12885-016-2485-9-
dc.identifier.urihttp://hdl.handle.net/10150/618723-
dc.description.abstractBackground: Patients with locally advanced esophageal cancer who are treated with trimodality therapy have a high recurrence rate. Preclinical evidence suggests that inhibition of cyclooxygenase 2 (COX2) increases the effectiveness of chemoradiation, and observational studies in humans suggest that COX-2 inhibition may reduce esophageal cancer risk. This trial tested the safety and efficacy of combining a COX2 inhibitor, celecoxib, with neoadjuvant irinotecan/cisplatin chemoradiation. Methods: This single arm phase 2 trial combined irinotecan, cisplatin, and celecoxib with concurrent radiation therapy. Patients with stage IIA-IVA esophageal cancer received weekly cisplatin 30 mg/m(2) plus irinotecan 65 mg/m(2) on weeks 1, 2, 4, and 5 concurrently with 5040 cGy of radiation therapy. Celecoxib 400 mg was taken orally twice daily during chemoradiation, up to 1 week before surgery, and for 6 months following surgery. Results: Forty patients were enrolled with stage IIa (30 %), stage IIb (20 %), stage III (22.5 %), and stage IVA (27.5 %) esophageal or gastroesophageal junction cancer (AJCC, 5th Edition). During chemoradiation, grade 3-4 treatment-related toxicity included dysphagia (20 %), anorexia (17.5 %), dehydration (17.5 %), nausea (15 %), neutropenia (12.5 %), diarrhea (10 %), fatigue (7.5 %), and febrile neutropenia (7.5 %). The pathological complete response rate was 32.5 %. The median progression free survival was 15.7 months and the median overall survival was 34.7 months. 15 % (n = 6) of patients treated on this study developed brain metastases. Conclusions: The addition of celecoxib to neoadjuvant cisplatin-irinotecan chemoradiation was tolerable; however, overall survival appeared comparable to prior studies using neoadjuvant cisplatin-irinotecan chemoradiation alone. Further studies adding celecoxib to neoadjuvant chemoradiation in esophageal cancer are not warranted.en
dc.description.sponsorshipNational Institute of Health [P50CA127003]; Pharmacia Oncologyen
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://bmccancer.biomedcentral.com/articles/10.1186/s12885-016-2485-9en
dc.rights© 2016 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).en
dc.subjectEsophageal canceren
dc.subjectNeoadjuvant therapyen
dc.subjectChemoradiationen
dc.subjectCyclooxygenase 2 inhibitionen
dc.titleNeoadjuvant irinotecan, cisplatin, and concurrent radiation therapy with celecoxib for patients with locally advanced esophageal canceren
dc.typeArticleen
dc.contributor.departmentUniv Arizona, Ctr Canc, St Josephs Hosp & Med Ctren
dc.identifier.journalBMC Canceren
dc.description.noteOpen Access Journalen
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen

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