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Article / Publication Details Abstract

Background: Neoadjuvant chemotherapy (nCT) or chemoradiotherapy (CRT) are accepted standards of care for the management of adenocarcinoma (AC) of esophagus and gastro-esophageal junction (GOJ). Summary: The MRC-OEO2 study established the role of 2 cycles of neoadjuvant cisplatin/fluoropyrimidine (FP). More recently, the FLOT-AIO4 study demonstrated the superiority of peri-operative FLOT chemotherapy (5FU, oxaliplatin and docetaxel) compared to ECX (epirubicin, cisplatin and capecitabine) regime. The results from the pivotal CROSS study established neoadjuvant CRT as a new standard of care in OG cancer. The survival benefit observed in FLOT and CROSS studies are similar [FLOT- HR 0.75 (0.62-0.92); CROSS - 0.741 (0.55-0.98)]. Key Messages : Both nCT and nCRT have been shown to be associated with survival benefit compared to surgery alone. We have performed a comprehensive review of the available evidence to define the optimum treatment algorithm and identify specific patient sub-groups who may be appropriate for the use of one or more of these neoadjuvant options.

S. Karger AG, Basel

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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