scholarly journals Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

2020 ◽  
Author(s):  
Liangyu Xu ◽  
Jianzhou Chen ◽  
Hong Guo ◽  
Ruihong Huang ◽  
Longjia Guo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Disease Progression ◽  
Oesophageal Cancer ◽  
Squamous Cell ◽  
Peripheral Blood ◽  
Tumour Progression ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Definitive Chemoradiotherapy

Abstract Background: Prediction of response to chemoradiotherapy is critical for the optimal management of oesophageal cancer, yet it is still an unmet clinical need. This study aims to evaluate the predictive potential of peri-treatment peripheral blood cells (PBC) in disease progression hazard in oesophageal cancer following chemoradiotherapy.Methods: 87 patients with primary oesophageal squamous cell carcinoma were subjected to definitive concurrent chemoradiotherapy in a phase II trial. PBC parameters (haemoglobin, neutrophils, platelets, lymphocytes and monocytes) were collected at 7 time points through the course of radiotherapy. The values of peri-treatment PBC parameters in predicting 3-year cumulative hazard of tumour progression were evaluated.Results: Patients with disease progression displayed distinct distribution patterns of peri-treatment PBC compared to patients without. Greater prediction capabilities for risk of locoregional disease progression were found in PBC collected after the start of radiotherapy compared to their pretreatment counterparts, and in individual parameters rather than cell-to-cell ratios. The most predictive PBC parameters were integrated by summation and designated as a PBC score (PBCS), which further augmented their predictive power. Patients divided according to their PBCS (high vs medium vs low) had significantly different 3-year cumulative hazards of locoregional progression (58% vs 29% vs 7%, P = 0.0017). Multivariate analysis confirmed that PBCS high (HR 12.2, 95%CI 2.0-76.3, P = 0.007) and medium (HR 5.8, 95%CI 1.2-27.7, P = 0.028) are independent indicators of locoregional progression.Conclusion: Peri-treatment PBCS can predict the long-term hazard of locoregional progression after definitive chemoradiotherapy in patients with oesophageal squamous cell carcinoma.

scholarly journals Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

2019 ◽  
Author(s):  
Jianzhou Chen ◽  
Liangyu Xu ◽  
Hong Guo ◽  
Ruihong Huang ◽  
Longjia Guo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Disease Progression ◽  
Oesophageal Cancer ◽  
Squamous Cell ◽  
Peripheral Blood ◽  
Tumour Progression ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Definitive Chemoradiotherapy

Abstract Background Prediction of response to chemoradiotherapy is critical for the optimal management of oesophageal cancer, yet it is still an unmet clinical need. This study aims to evaluate the predictive potential of peri-treatment peripheral blood cells (PBC) in disease progression hazard in oesophageal cancer following chemoradiotherapy.Methods 87 patients with primary oesophageal squamous cell carcinoma were subjected to definitive concurrent chemoradiotherapy in a phase II trial. PBC parameters (haemoglobin, neutrophils, platelets, lymphocytes and monocytes) were collected at 7 time points through the course of radiotherapy. The values of peri-treatment PBC parameters in predicting 3-year cumulative hazard of tumour progression were evaluated.Results Patients with disease progression displayed distinct distribution patterns of peri-treatment PBC compared to patients without. Greater prediction capabilities for risk of locoregional disease progression were found in PBC collected after the start of radiotherapy compared to their pretreatment counterparts, and in individual parameters rather than cell-to-cell ratios. The most predictive PBC parameters were integrated by summation and designated as a PBC score (PBCS), which further augmented their predictive power. Patients divided according to their PBCS (high vs medium vs low) had significantly different 3-year cumulative hazards of locoregional progression (58% vs 29% vs 7%, P = 0.0017). Multivariate analysis confirmed that PBCS high (HR 12.2, 95%CI 2.0-76.3, P = 0.007) and medium (HR 5.8, 95%CI 1.2-27.7, P = 0.028) are independent indicators of locoregional progression.Conclusion Peri-treatment PBCS can predict the long-term hazard of locoregional progression after definitive chemoradiotherapy in patients with oesophageal squamous cell carcinoma.

Nivolumab in advanced esophageal squamous cell carcinoma (ATTRACTION-1/ONO-4538-07): Minimum of five-year follow-up.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 207-207
Author(s):  
Ken Kato ◽  
Yuichiro Doki ◽  
Takashi Ura ◽  
Yasuo Hamamoto ◽  
Takashi Kojima ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Disease Progression ◽  
Squamous Cell ◽  
Group Performance ◽  
Objective Response

207 Background:ATTRACTION-1/ONO-4538-07 (AT-1), an open-label, single-arm, multicenter phase 2 clinical trial conducted in Japan, evaluated the clinical activity and safety of nivolumab in patients with advanced esophageal squamous cell carcinoma (ESCC) refractory/intolerant to fluoropyrimidine-, platinum-, and taxane-based chemotherapy. We previously reported the 2-year follow-up findings of AT-1, in which nivolumab demonstrated antitumor activity with a manageable safety profile for these patients. Here we report the final findings from AT-1 at a minimum follow-up of 5 years. Methods:Patients aged ≥20 years with an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0-1 received 3 mg/kg nivolumab intravenously every 2 weeks in 6-week cycles until disease progression or unacceptable toxicity. The primary endpoint was centrally-assessed objective response rate (ORR), defined as the proportion of patients whose best overall response was either a complete or partial response. Secondary endpoints included overall survival (OS), investigator-assessed ORR, progression-free survival (PFS), change in tumor burden, time to response, time to disease progression, and duration of response. Results:Between February 25 and November 14, 2014, a total of 65 patients were enrolled. Sixty-four patients were evaluated for the efficacy, and all patients were evaluated for the safety. At the final database lock on August 6, 2020, 11 (17.2%, 95% confidence interval [CI] 9.9-28.2) of 64 patients had an objective response by central assessment. The median OS was 10.8 months (95% CI, 7.4-13.9), and the estimated 5-year OS rate was 6.3% (95% CI, 2.0-14.0). The median PFS was 1.5 months (95% CI, 1.4-2.8), and the estimated 5-year PFS rate was 6.8% (95% CI, 2.2-15.1). Treatment-related adverse events that occurred with a frequency of > 10% were diarrhea and rash. The presentation will include characteristics of long-term survivors as well as detailed efficacy and safety data of nivolumab. Conclusions:This final assessment represents the longest follow-up of patients with advanced ESCC treated with nivolumab. Nivolumab demonstrated continued long-term efficacy in these patients based on a minimum of 5-year long-term survival update of AT-1. Furthermore, no new safety signals with nivolumab were identified during long-term follow-up. These findings are consistent with those of nivolumab monotherapy for various types of cancer. Clinical trial information: No.142422.

scholarly journals Comparison of short- and long-term outcomes between 3-field and modern 2-field lymph node dissections for thoracic oesophageal squamous cell carcinoma: a propensity score matching analysis

2019 ◽  
Vol 29 (3) ◽  
pp. 434-441 ◽  
Author(s):  
Ningbo Fan ◽  
Han Yang ◽  
Jiabo Zheng ◽  
Dongni Chen ◽  
Weidong Wang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Disease Free Survival ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Short And Long Term ◽  
Disease Free

Abstract OBJECTIVES Our goal was to compare short- and long-term outcomes between 3-field lymphadenectomy (3-FL) and modern 2-field lymphadenectomy (2-FL) in patients with thoracic oesophageal squamous cell carcinoma. METHODS We reviewed clinical outcomes for 298 patients with thoracic oesophageal squamous cell carcinoma who underwent 3-FL or modern 2-FL from March 2008 to December 2013 at a major cancer hospital in Guangzhou, southern China. Propensity score matching was used to balance baseline differences, and 83 pairs of cases were selected. Postoperative complications, recurrence patterns and survival outcomes were compared between the 2 groups. RESULTS Compared with modern 2-FL, 3-FL led to higher overall operative morbidity rates [78.3% vs 61.4%, odds ratio (OR) 2.266, 95% confidence interval (CI) 1.143–4.490; P = 0.019], with higher recurrent nerve palsy rates (47.0% vs 19.3%, OR 3.712, 95% CI 1.852–7.438; P < 0.0001), more respiratory failures (18.1% vs 6.0%, OR 3.441, 95% CI 1.189–9.963; P = 0.023) and longer postoperative hospital stays (23 vs 17 days, P = 0.002). The 5-year overall survival rate (58.5% vs 59.4%; P = 0.960) and the 5-year disease-free survival rate 50.1% vs 54.5%; P = 0.482) were comparable between the 2 groups. Multivariable analysis showed that additional cervical lymph node dissection was not associated with overall survival [hazard ratio (HR) 1.039, 95% CI 0.637–1.696; P = 0.878] and disease-free survival (HR 0.868, 95% CI 0.548–1.376; P = 0.547). The overall recurrence rate and cervical nodal recurrence rate were not significantly different between the 2 groups. CONCLUSIONS Additional cervical lymphadenectomy did not lead to added survival benefit when compared with modern 2-FL in patients with thoracic oesophageal squamous cell carcinoma. Recurrence was similar in patients undergoing 3-FL and modern 2-FL. 3-FL resulted in more postoperative complications.

Lactate dehydrogenase and baseline markers associated with clinical outcomes of advanced esophageal squamous cell carcinoma patients treated with camrelizumab (SHR-1210), a novel anti-PD-1 antibody.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15559-e15559
Author(s):  
Xi Wang ◽  
Bo Zhang ◽  
Xuelian Chen ◽  
Hongnan Mo ◽  
Dawei Wu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Lactate Dehydrogenase ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Disease Progression ◽  
Squamous Cell ◽  
Peripheral Blood ◽  
Group Performance ◽  
Blood Biomarkers

e15559 Background: A small proportion of patients with advanced esophageal squamous cell carcinoma (ESCC) could benefit from immune checkpoint inhibitors, and reliable peripheral blood biomarkers for outcomes of anti-PD-1 immunotherapy were not identified in ESCC. Methods: A total of 43 patients were retrospectively reviewed in the ESCC cohort of a phase I trial from our center. All patients received intravenous camrelizumab (SHR-1210), a novel anti-PD-1 antibody, at a dose of 60 mg, 200 mg or 400 mg (4-week interval after first dose followed by a 2-week schedule) and repeated every two weeks until disease progression or intolerable toxicity. The associations between lactate dehydrogenase (LDH) as well as other peripheral blood biomarkers at baseline and the efficacy of camrelizumab were also investigated. Results: With a median follow-up of 19.6 months, the overall response rate was 25.6% (11/43), including one complete response. Median progression-free survival (PFS) and overall survival were 2.0 months (95% CI: 0-4.1 months) and 8.0 months (95% CI: 7.2-8.8 months), respectively. Notably, four patients achieved a PFS exceeding 12 months, including three patients with a long-lasting duration of response over 1 year. Patients with an elevated baseline lactate dehydrogenase had lower tumor response rates (8.3% vs. 32.3%, p = 0.02) as well as shorter PFS (median: 1.8 vs. 4.0 months; HR 0.39, p = 0.002) and overall survival (median: 4.2 vs. 10.4 months; HR 0.22, p < 0.0001) compared with patients with normal levels. An increase of lactate dehydrogenase level during treatment was significantly associated with disease progression (p = 0.014). Multivariate Cox analysis identified LDH (HR = 0.18), C-reactive protein (HR = 0.27), number of involved organs (HR = 0.31), absolute monocyte count (HR = 0.33) and Eastern Cooperative Oncology Group performance status (HR = 0.36) as independent prognostic factors. Conclusions: Serum LDH, as is readily available in routine clinical practice, is a potential marker for response and a powerful independent factor for survival in advanced ESCC patients receiving anti-PD-1 treatment.

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