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Immunotherapy, Chemotherapy, Radiotherapy for Esophageal Cancer?
Immunotherapy, Chemotherapy, Radiotherapy for Esophageal Cancer are a lot of treatments for one cancer patient. I mean, that’s a lot of toxicity for one body to manage.
The challenge is that, depending on your stage at diagnosis, esophageal cancers have a poor prognosis. Therefore, conventional oncology can treat the patient aggressively. The study linked below is significant because immunotherapy has been added to the treatment plan in hopes of improving overall survival.
Outcomes appear to improved yet there seemed to be serious side effects- “Rates of grade 3-4 toxicity were comparable to historical controls..”
The correlation between composition of the gut microbiota with anti-PD-1 efficacy in cancer patients
The solution? Evidence-based non-conventional therapies have been shown to reduce the risk of side effects while enhancing the efficacy of treatment.
I am a long-term cancer survivor of a different cancer. Aggressive treatments created a host of short-term, long-term, and late-stage side effects. I wish I knew then what I know now.
Have you been diagnosed with esophageal cancer? What is the stage of your cancer? What treatment plan are you considering? Scroll down the page, post a question or comment and I will reply to you ASAP.
Hang in there,
David Emerson
- Cancer Survivor
- Cancer Coach
- Director PeopleBeatingCancer
Pembrolizumab, Radiotherapy, and Chemotherapy in Neoadjuvant Treatment of Malignant Esophago-gastric Diseases (PROCEED): A single-arm phase 2 trial
Abstract
Introduction
Esophagogastric cancers are common and carry a poor prognosis. A standard option for locally advanced disease has been neoadjuvant chemoradiation (CRT) followed by surgical resection. The primary goal of this study was to investigate whether the addition of pembrolizumab to neoadjuvant CRT improves pathologic complete response (pCR) rates, compared to historical controls.
Methods
This is a single-institution, prospective, single-arm phase 2 trial (NCT03064490). Patients received three cycles of pembrolizumab (200 mg every 3 weeks) concurrent with neoadjuvant CRT (45 Gy/25 fractions, concurrent weekly carboplatin and paclitaxel), followed by surgical resection. Patients were eligible to receive three additional cycles of adjuvant pembrolizumab if they did not experience significant toxicity during neoadjuvant treatment. Pathologic response and acute toxicities were evaluated. Survival and recurrence data were tabulated.
Results
A total of 35 patients were enrolled over 5 years, with 30 patients completing prescribed neoadjuvant treatment followed by surgical resection. Eleven of 30 patients (36·7%) experienced a pCR and 15/30 patients (50%) experienced a major pathologic response. Rates of grade 3-4 toxicity were comparable to historical controls, and there were no grade 5 toxicities. Median progression-free and overall survival were numerically higher in patients who experienced a major pathologic response.
Conclusion
The addition of pembrolizumab to neoadjuvant CRT followed by surgical resection was overall well-tolerated and resulted in numerically higher rates of pCR compared to historical controls. Further studies with optimized patient selection are warranted to validate the efficacy of this treatment paradigm.
Immunotherapy Chemotherapy Radiotherapy for Esophageal Cancer Immunotherapy Chemotherapy Radiotherapy for Esophageal Cancer