KEY TAKEAWAYS
- The study aimed to investigate the rates of pCR among patients receiving neoadjuvant chemoradiation and chemo for nonmetastatic esophageal cancer.
- Researchers noticed considerable variation in pCR rates among patients receiving neoadjuvant chemo(radiation) with squamous cell carcinoma patients; further investigation is ongoing.
Charles E. Gaber and the team aimed to assess the existing estimates of pathologic complete response (pCR) rates among patients undergoing neoadjuvant therapy for nonmetastatic esophageal cancer lacking precision and synthesis.
Neoadjuvant chemoradiation and chemotherapy (chemo) are standard treatments for this condition, but their benefits are primarily seen in patients achieving pCR. However, the precise rates of pCR in this population remain unclear.
They performed an inclusive analysis, conducting an independently funded systematic review and meta-analysis (PROSPERO CRD42023397402) of pCR rates among patients diagnosed with esophageal cancer treated with neoadjuvant chemo(radiation). Studies were identified from Medline, EMBASE, and CENTRAL database searches. Eligible trials published from 1992 to 2022 on nonmetastatic esophageal cancer, including the gastroesophageal junction, were included. Histology-specific pooled pCR prevalence was determined using the Freeman-Tukey transformation and a random effects model.
About 84 studies with 6451 patients were included after the eligibility assessment. The pooled prevalence of pCR after neoadjuvant chemo in squamous cell carcinomas was 9% (95% CI: 6%-14%), ranging from 0% to 32%. After neoadjuvant chemoradiation, the pooled prevalence of pCR in squamous cell carcinomas was 32% (95% CI: 26%-39%), ranging from 8% to 66%. For adenocarcinoma, the pooled prevalence of pCR was 6% (95% CI: 1%-12%) after neoadjuvant chemo and 22% (18%-26%) after neoadjuvant chemoradiation.
The study concluded that less than one-third of patients with esophageal cancer who undergo neoadjuvant chemo(radiation) experience pCR. Squamous cell carcinoma patients demonstrated higher pCR rates compared to adenocarcinomas. These pooled pCR rates may serve as crucial benchmarks for future trial design as pCR becomes increasingly utilized as an endpoint in neoadjuvant trials. The study received no funds.
Source: https://pubmed.ncbi.nlm.nih.gov/38457244/
Gaber CE, Sarker J, Abdelaziz AI, et al. (2024). “Pathologic complete response in patients with esophageal cancer receiving neoadjuvant chemotherapy or chemoradiation: A systematic review and meta-analysis.” Cancer Med. 2024 Feb;13(4):e7076. doi: 10.1002/cam4.7076. PMID: 38457244; PMCID: PMC10923050.
