P2-025Down-staging and histological effects might be predictive factors for DOC+CDDP+5-FU for esophageal cancer

Abstract Background In Japan, two courses of CDDP+5-FU (CF) therapy followed by surgery is accepted as a standard treatment for stage II/III esophageal cancer (EC) based on the results of the JCOG9907 trial. However, in some cases, especially stage III disease, the anti-tumor effect of CF is insufficient. Therefore, a three-arm phase III trial (neoadjuvant [NAC] setting: CF vs. CF+radiation vs. DOC+CF [DCF]) is on-going. We have aggressively performed DCF therapy mainly in NAC settings since October 2014. We herein review the outcomes of DCF therapy. Methods Twenty-three patients (20 men, 3 women; median age: 70.0 years) with stage III or IV EC who received DCF therapy (October 2014 to February 2018) were retrospectively reviewed. Results The response rate was 43.5%. Down-staging was achieved in 11 patients (47.8%) over the course of treatment. Twenty-one patients transited to surgery, and 20 of them underwent R0 resection. One patient with disease progression was converted to chemoradiation therapy. Histological efficacy was observed in 21 patients, including 7 cases of grade 2. Those treated with DCF therapy who achieved down-staging had a significantly longer relapse-free survival (RFS) than those without down-staging (median RFS: not reached vs. 167 days, p = 0.0011) and also tended to have a longer overall survival (OS) than those without down-staging (MST: not reached vs. 824 days, p = 0.0637). Patients receiving CF therapy with down-staging tended to show a better RFS and OS than those without down-staging, although not to a significant degree. Patients receiving DCF therapy with grade ≥1b histological efficacy tended to have a longer RFS than those with grade Conclusions These findings suggest that down-staging and the histological efficacy might be predictive factors for DCF therapy for EC.