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Published in: memo - Magazine of European Medical Oncology 1/2019

01-03-2019 | Esophageal Cancer | case report

The path of an esophageal carcinoma patient from curative to palliative treatment

Authors: Ercan Müldür, MD, Karl Mayrhofer, Wolfgang Hilbe

Published in: memo - Magazine of European Medical Oncology | Issue 1/2019

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Summary

We hereby report the course and management of a patient with human epidermal growth factor receptor 2 negative esophageal cancer who received neoadjuvant chemoradiation, surgical resection and subsequently palliative therapy for recurrent disease. The critical role of the staging procedure is discussed. Additionally the options of systemic palliative therapies are presented and the rationale for immuno-oncologic treatment is highlighted. The patient received pembrolizumab as second-line therapy, which unfortunately did not result in a response and caused minor autoimmune side effects.
Literature
1.
go back to reference van Hagen P, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074–84.CrossRef van Hagen P, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074–84.CrossRef
2.
go back to reference Lewis I. The surgical treatment of carcinoma of the oesophagus with special reference to a new operation for growths of the middle third. Br J Surg. 1946;34(133):18–31.CrossRef Lewis I. The surgical treatment of carcinoma of the oesophagus with special reference to a new operation for growths of the middle third. Br J Surg. 1946;34(133):18–31.CrossRef
3.
go back to reference Al-Batran S‑E, et al. LBA-008Docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) versus epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/ECX) as perioperative treatment of resectable gastric or gastro-esophageal junction adenocarcinoma: The multicenter, randomized phase 3 FLOT4 trial (German Gastric Group at AIO). Ann Oncol. 2017;28(suppl_3). https://doi.org/10.1093/annonc/mdx302.007 CrossRef Al-Batran S‑E, et al. LBA-008Docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) versus epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/ECX) as perioperative treatment of resectable gastric or gastro-esophageal junction adenocarcinoma: The multicenter, randomized phase 3 FLOT4 trial (German Gastric Group at AIO). Ann Oncol. 2017;28(suppl_3). https://​doi.​org/​10.​1093/​annonc/​mdx302.​007 CrossRef
4.
go back to reference Fuchs CS, et al. Safety and efficacy of pembrolizumab monotherapy in patients with previously treated advanced gastric and gastroesophageal junction cancer: Phase 2 clinical KEYNOTE-059 trial. Jama Oncol. 2018;4(5):e180013.CrossRef Fuchs CS, et al. Safety and efficacy of pembrolizumab monotherapy in patients with previously treated advanced gastric and gastroesophageal junction cancer: Phase 2 clinical KEYNOTE-059 trial. Jama Oncol. 2018;4(5):e180013.CrossRef
5.
go back to reference Nishino M, et al. Anti-PD-1-related pneumonitis during cancer immunotherapy. N Engl J Med. 2015;373(3):288–90.CrossRef Nishino M, et al. Anti-PD-1-related pneumonitis during cancer immunotherapy. N Engl J Med. 2015;373(3):288–90.CrossRef
6.
go back to reference Villadolid J, et al. Immune checkpoint inhibitors in clinical practice: update on management of immune-related toxicities. Transl Lung Cancer Res. 2015;4(5):560–75.PubMedPubMedCentral Villadolid J, et al. Immune checkpoint inhibitors in clinical practice: update on management of immune-related toxicities. Transl Lung Cancer Res. 2015;4(5):560–75.PubMedPubMedCentral
7.
go back to reference Li Z, et al. Correlation of pathological complete response with survival after neoadjuvant chemotherapy in gastric or gastroesophageal junction cancer treated with radical surgery: A meta-analysis. PLoS ONE. 2018;13(1):e189294. Li Z, et al. Correlation of pathological complete response with survival after neoadjuvant chemotherapy in gastric or gastroesophageal junction cancer treated with radical surgery: A meta-analysis. PLoS ONE. 2018;13(1):e189294.
8.
go back to reference Rizvi FH, et al. Complete pathological response after neoadjuvant treatment in locally advanced esophageal cancer predicts long term survival: A retrospective cohorte study. Int J Surg. 2014;12(6):621–5.CrossRef Rizvi FH, et al. Complete pathological response after neoadjuvant treatment in locally advanced esophageal cancer predicts long term survival: A retrospective cohorte study. Int J Surg. 2014;12(6):621–5.CrossRef
9.
go back to reference Donahue JM, et al. Complete pathologic response after neoadjuvant chemoradiotherapy for esophageal cancer is associated with enhanced survival. Ann Thorac Surg. 2009;87(2):392–9.CrossRef Donahue JM, et al. Complete pathologic response after neoadjuvant chemoradiotherapy for esophageal cancer is associated with enhanced survival. Ann Thorac Surg. 2009;87(2):392–9.CrossRef
10.
go back to reference You JJ, et al. Clinical utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the staging of patients with potentially resectable esophageal cancer. J Thorac Oncol. 2013;8(12):1563–9.CrossRef You JJ, et al. Clinical utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the staging of patients with potentially resectable esophageal cancer. J Thorac Oncol. 2013;8(12):1563–9.CrossRef
11.
go back to reference Meyers BF, et al. The utility of positron emission tomography in staging of potentially operable carcinoma of the thoracic esophagus: Results of the American College of Surgeons Oncology Group Z0060 trial. J Thorac Cardiovasc Surg. 2007;133(3):738–745.e1.CrossRef Meyers BF, et al. The utility of positron emission tomography in staging of potentially operable carcinoma of the thoracic esophagus: Results of the American College of Surgeons Oncology Group Z0060 trial. J Thorac Cardiovasc Surg. 2007;133(3):738–745.e1.CrossRef
12.
go back to reference Young K, et al. Ramucirumab for advanced gastric cancer or gastro-oesophageal junction adenocarcinoma. Therap Adv Gastroenterol. 2015;8(6):373–83.CrossRef Young K, et al. Ramucirumab for advanced gastric cancer or gastro-oesophageal junction adenocarcinoma. Therap Adv Gastroenterol. 2015;8(6):373–83.CrossRef
13.
go back to reference Shitara K, et al. Pembrolizumab versus paclitaxel for previously treated, advanced gastric or gastro-oesophageal junction cancer (KEYNOTE-061): a randomised, open-label, controlled, phase 3 trial. Lancet. 2018;392(10142):123–33.CrossRef Shitara K, et al. Pembrolizumab versus paclitaxel for previously treated, advanced gastric or gastro-oesophageal junction cancer (KEYNOTE-061): a randomised, open-label, controlled, phase 3 trial. Lancet. 2018;392(10142):123–33.CrossRef
14.
go back to reference Le DT, et al. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science. 2017;357(6349):409–13.CrossRef Le DT, et al. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science. 2017;357(6349):409–13.CrossRef
15.
go back to reference Le DT, et al. PD-1 blockade in mismatch repair deficient non-colorectal gastrointestinal cancers. J Clin Oncol. 2016;34(4_suppl):195–195.CrossRef Le DT, et al. PD-1 blockade in mismatch repair deficient non-colorectal gastrointestinal cancers. J Clin Oncol. 2016;34(4_suppl):195–195.CrossRef
Metadata
Title
The path of an esophageal carcinoma patient from curative to palliative treatment
Authors
Ercan Müldür, MD
Karl Mayrhofer
Wolfgang Hilbe
Publication date
01-03-2019
Publisher
Springer Vienna
Published in
memo - Magazine of European Medical Oncology / Issue 1/2019
Print ISSN: 1865-5041
Electronic ISSN: 1865-5076
DOI
https://doi.org/10.1007/s12254-019-0475-8

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