Medicine and Health

Efficacy of early PET-CT directed switch to carboplatin and paclitaxel based definitive chemoradiotherapy in patients with oesophageal cancer who have a poor early response to induction cisplatin and capecitabine in the UK: a multi-centre randomised controlled phase II trial

S. Mukherjee, C. N. Hurt, et al.

This groundbreaking multi-center trial explored how early PET-CT scans could guide chemotherapy choices in oesophageal cancer patients. Conducted by a team including Somnath Mukherjee and Christopher N Hurt among others, the study revealed that switching treatment may not be beneficial. Findings suggest a need to reassess early metabolic response assessment in guiding therapy, especially for oesophageal squamous cell carcinoma.

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Abstract

This multi-center, randomized, phase II trial investigated the use of early (day 14) PET-CT to guide a switch in chemotherapy for oesophageal cancer patients with poor response to induction cisplatin/capecitabine. Non-responders were randomized to continue cisplatin/capecitabine or switch to carboplatin/paclitaxel. The trial was stopped early due to futility and potential harm. In oesophageal squamous cell carcinoma (OSCC), cisplatin/capecitabine was superior to carboplatin/paclitaxel, indicating that early metabolic response assessment is not prognostic and shouldn't guide therapy personalization in this context. Results for oesophageal adenocarcinoma were inconclusive due to small sample size.

Publisher

The Lancet

Published On

Jul 01, 2023

Authors

Somnath Mukherjee, Christopher N Hurt, Richard Adams, Andrew Bateman, Kevin M Bradley, Sarah Bridges, Stephen Falk, Gareth Griffiths, Sarah Gwynne, Christopher M Jones, Philip J Markham, Tim Maughan, Lisette S Nixon, Ganesh Radhakrishna, Rajarshi Roy, Simon Schoenbuchner, Hamid Sheikh, Emiliano Spezi, Maria Hawkins, Thomas D L Crosby

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