PS01.52: New Chemotherapy Regimen: Does it Really Work for Esophageal Cancer Adenocarcinoma?: Topic: Medical Oncology.

Neoadjuvant chemotherapy for esophageal cancer changed over last years with the current most used regimen being EOX(Epirubicin,Oxaloplatin &Xeloda)for adenocarcinoma but this treatment still carries many adverse events(AE)as identified by NCI-CTCAEv.4.Among R0(complete resection)group, we sought to investigate a modification for current ones seeking a better response rate, lower AE rate and better quality of life(QoL). This is a pilot study(Sep.2008-Dec.2014)involving Taxol/Carboplatin/ Xeloda(TCX(paclitaxel 80 mg/m2days 1 and 8, carboplatin 5AUC day 1, capecitabine 750mg/m2 BID for 14 days)){Ruoff, C.A.,Hong,B.,Kaplan,et al,Single-center experience with paclitaxel(T),carboplatin(C),and capecitabine(X) in treatment of advanced esophagogastric cancer.In ASCO-Gastrointestinal Cancer Symposium,2013;116}. Patients were followed through chemotherapy course to capture grade 1,2,3,4and5 AE(Mild, Moderate,Severe,Life-threatening and Death respectively).Kaplan-Meier survival curves were used to identify disease free survival(DFS).QoL was assessed using Functional Assessment of Cancer Therapy-Esophagus(FACT-E)questionnaire 12 months or more post-operatively. Among our database, 8 patients received neoadjuvant-TCX for adenocarcinoma with median age 61(51-75) years, BMI28.8(20.1-33.6).Most patients were male, performance status of 0(7 patients).They had lower or GEJ-adenocarcinoma predominantly(7 patients).Clinical stage IIand III were present in 2 and 6 patients respectively. Pathological stage I,IIand III were present in 3, 3and2patients respectively. Median pre-induction PET-standardized uptake value(PET-SUV)was 10.1 vs 3.6 post-induction(p=0.014)with median PET-SUV decrease percent of 75.3%. 87.5% were clinical responder(>50% reduction)and 75% were radiological responder(>50% decrease in PET-SUV).25% of our cohort received adjuvant treatment. Grade 2-3 toxicity occurred in 44.4% of the patients(37.5% grade 2, 12.5% grade 3 and none had grade 4or5).Hematologic AE were the most frequent(anemia 87.5%,neutropenia 50%(grade1,2,and3 in 2,1and1 patients respectively),leukopenia 25% and thrombocytopenia 37.5%)followed by diarrhea (25%).No patient had neutropenic sepsis. Mean DFS was 66months. 3-and 5-years DFS was 87.5 and72.9% respectively( Figure1A). QoL was improved compared to published data(Figure1B). TCX is a novel,safe regimen and carries a low AE rate(mostly low grade AE).It is associated with reasonable DFS and better QoL.However, large scale RCT is necessary and warranted.