Back to Search Start Over

Results and Molecular Correlates from a Pilot Study of Neoadjuvant Induction FOLFIRINOX Followed by Chemoradiation and Surgery for Gastroesophageal Adenocarcinomas.

Authors :
Wo JY
Clark JW
Eyler CE
Mino-Kenudson M
Klempner SJ
Allen JN
Keane FK
Parikh AR
Roeland E
Drapek LC
Ryan DP
Corcoran RB
Van Seventer E
Fetter IJ
Shahzade HA
Khandekar MJ
Lanuti M
Morse CR
Heist RS
Ulysse CA
Christopher B
Baglini C
Yeap BY
Mullen JT
Hong TS
Source :
Clinical cancer research : an official journal of the American Association for Cancer Research [Clin Cancer Res] 2021 Dec 01; Vol. 27 (23), pp. 6343-6353. Date of Electronic Publication: 2021 Jul 30.
Publication Year :
2021

Abstract

Purpose: We performed a NCI-sponsored, prospective study of neoadjuvant FOLFIRINOX followed by chemoradiation with carboplatin/paclitaxel followed by surgery in patients with locally advanced gastric or gastroesophageal cancer.<br />Patients and Methods: The primary objective was to determine completion rate of neoadjuvant FOLFIRINOX × 8 followed by chemoradiation. Secondary endpoints were toxicity and pathologic complete response (pCR) rate. Exploratory analysis was performed of circulating tumor DNA (ctDNA) to treatment response.<br />Results: From October 2017 to June 2018, 25 patients were enrolled. All patients started FOLFIRINOX, 92% completed all eight planned cycles, and 88% completed chemoradiation. Twenty (80%) patients underwent surgical resection, and 7 had a pCR (35% in resected cohort, 28% intention to treat). Tumor-specific mutations were identified in 21 (84%) patients, of whom 4 and 17 patients had undetectable and detectable ctDNA at baseline, respectively. Presence of detectable post-chemoradiation ctDNA ( P = 0.004) and/or postoperative ctDNA ( P = 0.045) were associated with disease recurrence.<br />Conclusions: Here we show neoadjuvant FOLFIRINOX followed by chemoradiation for locally advanced gastroesophageal cancer is feasible and yields a high rate of pCR. ctDNA appears to be a promising predictor of postoperative recurrence. See related commentary by Catenacci, p. 6281 .<br /> (©2021 American Association for Cancer Research.)

Details

Language :
English
ISSN :
1557-3265
Volume :
27
Issue :
23
Database :
MEDLINE
Journal :
Clinical cancer research : an official journal of the American Association for Cancer Research
Publication Type :
Academic Journal
Accession number :
34330715
Full Text :
https://doi.org/10.1158/1078-0432.CCR-21-0331