scholarly journals Personalized Kampo Medicine Facilitated Both Cytotoxic T Lymphocyte Response and Clinical Benefits Induced by Personalized Peptide Vaccination for Advanced Esophageal Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Daisuke Muroya ◽  
Shigeru Yutani ◽  
Shigeki Shichijo ◽  
Akira Yamada ◽  
Shinjiro Sakamoto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Clinical Study ◽  
Cytotoxic T Lymphocyte ◽  
Progression Free Survival ◽  
Kampo Medicine ◽  
Prospective Clinical Study ◽  
Advanced Esophageal Cancer ◽  
Peptide Vaccination ◽  
Clinical Benefits ◽  
Ctl Responses

We retrospectively evaluated if personalized Kampo medicine (PKM) could facilitate CTL responses and clinical benefits induced by personalized peptide vaccination (PPV), in which HLA-matched vaccines were selected and administered based on the preexisting host immunity, for advanced esophageal cancer (aEC) patients. Among 34 aEC patients entered in the clinical study, 23 patients received PKM and PPV without (n=12) or with chemotherapy (n=11), while the remaining 11 patients did not receive PKM but received PPV without (n=6) or with chemotherapy (n=5), respectively. Incidence of adverse events was significantly lower or higher in PKM and PPV arm (n=23) or PPV and chemotherapy arm (n=16) as compared to that of the counter arm (n=11or 18), respectively. Postvaccination PBMCs from the patients undergoing PKM and PPV showed significantly higher CTL responses as compared to the counter arm. The median progression-free survival (PFS) or median survival time (MST) of 34 patients was 2.9 or 7.6 months, respectively. The combination therapy in PPV and PKM arm, but not that in PPV and chemotherapy arm, significantly (P=0.02) prolonged MST. These results could warrant a next step of prospective clinical study of PKM and PPV for aEC patients.

179 FEASIBILITY AND ONCOLOGICAL OUTCOME OF CHEMORADIATION WITH INTENSIFIED IMRT IN LOCALLY ADVANCED ESOPHAGEAL CANCER

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
R Innocente ◽  
F Navarria ◽  
R Petri ◽  
E Palazzari ◽  
M Gigante ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Tumor Volume ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Oncological Outcome ◽  
Advanced Esophageal Cancer ◽  
Free Survival ◽  
Ecog Ps ◽  
Locally Advanced Esophageal Cancer

Abstract   To assess safety, feasibility and efficacy of an intensified preoperative IMRT and concomitant carboplatin and paclitaxel-based chemotherapy (Carbo/Tax CT) in patients (pts) with locally advanced esophageal cancer (LAEC) treated at our Institution. Methods a retrospective analysis of toxicity (CTCAE 4.03), progression free survival (PFS) and overall survival (OS) of pts affected by LAEC, treated with preoperative intensified radiotherapy (IMRT) and weekly concurrent carboplatin and paclitaxel-based chemotherapy (CT) according to the CROSS trial, between February 2016 and October 2019, at the Centro di Riferimento Oncologico, Aviano (CRO). Results Sixty-nine consecutive pts, 57(82.6%) males, were treated. The median age was 69 yrs (38–85), the ECOG PS 0–2. All pts underwent concurrent chemoradiotherapy, IMRT technique, 45 Gy/25 to PTV1 (primary tumor volume + regional nodes), a simultaneous boost from 52.5Gy to 54Gy to PTV2 (gross tumor volume) and weekly concurrent carboplatin (AUC2) and paclitaxel (50 mg/m2). Induction CT was administered to 17 pts. All pts completed RT with median 4 (1–5) CT cycles. Median follow-up was 8 months (4–17); 2-yr PFS and OS were 49.0% and 80.3%, respectively. At 2 yrs, local recurrence rate was 8.4% (CI 95%: 2.6%–18.8%). Conclusion Preoperative intensified IMRT with concomitant Carbo/Tax CT in pts with LAEC appears safe and feasible with promising oncological outcome and needs to be confirmed in a larger series of pts.

A prospective phase II trial of a S-1/cisplatin-based chemoradiotherapy for locoregionally advanced esophageal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14559-e14559
Author(s):  
Byoung Chul Cho ◽  
Hyun Chang ◽  
Yong Chan Lee ◽  
Dae Joon Kim ◽  
Mi Jin Yun ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Phase Ii ◽  
Survival Data ◽  
Phase Ii Trial ◽  
Clinical Stage ◽  
Progression Free Survival ◽  
Similar Efficacy ◽  
Phase Iii ◽  
Concurrent Chemoradiation ◽  
Advanced Esophageal Cancer

e14559 Background: Concurrent chemoradiation has similar efficacy as surgery for esophageal cancer. Phase II trial was carried out to evaluate the efficacy and safety of chemoradiation with S-1 and cisplatin in locoregionally advanced esophageal cancer. Methods: Eligible patients had stage IIA-IVA esophageal cancer. Patients received two cycles of S-1 (days 1 to 14 and 22 to 35) and cisplatin (day 1 and 22) with concurrent radiotherapy (50.4 Gy total: 1.8 Gy/fraction). Esophagectomy was performed between week 12 and 18 as determined by the specialist multidisciplinary team meeting. Results: Sixty patients were enrolled between March 2008 and August 2011. Of the 60 patients entered, 59 patients were eligible. Clinical stage was ≥T3 in 28 patients (47%) and N1 in 43 patients (73%), with squamous cell carcinoma histology in 57 patients (97%). Fifty-four patients (90%) completed the planned treatment. After the chemoradiation, clinical tumor response rate was 62.7%. The primary grade 3/4 toxicities included neutropenia (24%) and esophagitis (8.5%). All three patients died during chemoradiation (two from pneumonia and one from gastrointestinal origin septic shock). Twenty-five patients (42%) underwent esophagectomy following chemoradiation and 15 (60%) achieved complete pathologic regression. At the median follow-up duration of 34.6 months, the estimated overall survival and progression-free survival rate at 2-year was 56.5% and 45.9%, respectively. Conclusions: Concurrent chemoradiation with S-1 and cisplatin showed an encouraging activity with high complete pathologic regression. Survival data was promising compared with historical data with 5-FU/cisplatin and should be confirmed in a randomized phase III trial. Toxicities were significant but clinically manageable.

A phase II trial of definitive chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) in advanced esophageal cancer (KDOG 0501-P2).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4070-4070
Author(s):  
Katsuhiko Higuchi ◽  
Shouko Komori ◽  
Satoshi Tanabe ◽  
Chikatoshi Katada ◽  
Mizutomo Azuma ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Phase Ii ◽  
Response Rate ◽  
Tnm Classification ◽  
Progression Free Survival ◽  
Late Toxicity ◽  
Thoracic Esophagus ◽  
Advanced Esophageal Cancer ◽  
Definitive Chemoradiotherapy ◽  
Grade 3

4070 Background: Our previous phase I study (Radiother Oncol 2008,87:398) provided evidence that definitive chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) was tolerable and active in patients with advanced esophageal cancer (AEC). This phase II study was conducted to confirm the efficacy and toxicity of DCF-R in AEC. Methods: Patients with previously untreated carcinoma of the thoracic esophagus who had T4 tumors, M1 lymph-node metastasis, or both received an infusion of docetaxel (35 mg/m2) and an infusion of cisplatin (40 mg/m2) on day 1 and a continuous infusion of 5-fluorouracil (400mg/m2/day) on days 1-5, every 2 weeks, plus concurrent radiation (RT). The total RT dose was initially 61.2, but was lowered to multiple-field irradiation with 50.4 Gy to decrease esophagitis and late toxicity. Consequently, the number of cycles of DCF administered during RT was modified from 4 to 3. After DCF-R, patients received at least 2 cycles of DCF (docetaxel 40 mg/m2 on day 1, cisplatin 60 mg/m2 on day 1, and 5-fluorouracil 600 mg/m2on days 1-5, every 4 weeks). The primary endpoint was the clinical complete response rate (cCRR). Secondary endpoints were response rate (RR), progression free survival (PFS), overall survival, and safety. Results: 42 patients (36 men, 6 women) were enrolled. The median age was 62 years (range: 46-75). PS 0/1/2 was 14/25/3. TNM classification T4M0/non-T4M1LYM/T4M1LYM was 20/12/10. The total scheduled dose of RT 61.2Gy /50.4Gy was 12/30 patients. The RR was 90.5% and the cCRR was 52.4% (95% CI:37.3-67.5%). As of January 2013, the median PFS was 11.1 months and the median survival time was 23.1 months. Grade 3 or higher major toxicities comprised leukopenia (71.4%), neutropenia (57.2%), anemia (16.7%), febrile neutropenia (38.1%), anorexia (31.0%), and esophagitis (28.6%). There was one treatment-related death caused by aspiration pneumonia. Grade 3 or higher late toxicities comprised one pericardial effusion (Grade 4), one case of esophagitis (Grade 3), and one case of thoracic aortic aneurysm (Grade 3). Conclusions: DCF-R frequently caused myelosuppression, but was highly active and suggested be a promising regimen in AEC. Clinical trial information: 000002029.

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