Common Trials for Oesophageal cancer neoadjuvant chemotherapy
CROSS trial was the first large trial and has been the benchmark. It examined chemo (ECF/ECX) + surgery with surgery alone. Showed increased survival (49 months vs 24 months), higher R0 resections and with few side effects
RTOG trial gave pre AND post-op chemo but found no improvement in survival
MRC OEO2 (5-FU/cisplatin) showed that 5-FU with cisplatin increased survival, with 5-year survival of 23% vs 17%
ACCORD trial (French) also confirmed that 5-FU with cisplatin had 5-year survival of 38% vs 24%
Therefore, based on the ACCORD and MAGIC trials, 2-week of neoadjuvant chemo is the standard of care
FLOT-4 (Docetaxil, Oxaliplatin, 5-FU and Folic acid) is a German trial that randomised to ECF/ECX vs FLOT
Looked at pathological response (16% with FLOT vs 6% complete; 37% had some response)
3-year survival was 57%
OEO-5
5-FU/cisplatin vs ECX
No survival benefit at 3 years
Results are awaited on…
Neo-AEGIS: CROSS vs MAGIC
ESOPEC: CROSS vs FLOT