Since better locoregional control would probably improve survival rates, we added cetux-RT preoperatively (Fig. was not started because of adverse events (AEs) related to preoperative chemotherapy; one patient had progressive disease. Addition of cetux-RT was well tolerated and did not interfere with the resectability rate (100%). However, the pCR rate was 0, and 50% of patients experienced serious adverse events (SAEs) postoperatively. == Conclusion. == With 12 patients enrolled, the lack of initial indicators of efficacy and a high incidence of postoperative SAEs prompted us to end this study prematurely. Perioperative ECX was associated with considerable toxicity, and further treatment intensification is usually problematic. == Abstract == .cetux-RT .IIECX3cetux-RTECX3pCR .1261cetux-RT5AEcetux-RT1Cetux-RT100%pCR050%AESAE .12SAEECXThe Oncologist2014; 19:1-2 == Discussion == Long-term survival in patients with resectable esophageal adenocarcinoma remains poor, with a 5-12 months survival rate of only 20%42% [1]. Perioperative ECX chemotherapy has improved survival rates but failed to deliver a significant proportion of pathologic complete responses. Since better locoregional Ecdysone control would probably improve survival rates, we added cetux-RT preoperatively (Fig. 1). == Physique 1. == Treatment schedule. ECX: epirubicin (day 1, 50 mg/m2), cisplatin (day 1, 60 mg/m2), capecitabine (days 121, 1,250 mg/m2); Cetux: cetuximab (day 1, Ecdysone 400 mg/m2); Cetux-RT: cetuximab 250 mg/m2weekly, radiotherapy 45 Gy (25 1.8 Gy). Abbreviations: Ecdysone Cetux, cetuximab; Cetux-RT, cetuximab plus radiotherapy; ECX: epirubicin, cisplatin, and capecitabine; wks, weeks. We found that intensification of the preoperative treatment was poorly feasible, as 42% of patients discontinued treatment because of toxicity of preoperative ECX. Addition of cetux-RT was well tolerated Rabbit polyclonal to MTOR (Table 1) and did not interfere with the resectability rate; however, the extension of the preoperative treatment led to a high postoperative complication rate. The combination of an extensive surgical procedure, the type of disease, a prolonged preoperative period, and high preoperative toxicity may have contributed to the postoperative toxicity of this regimen. == Table 1. == Adverse events related to cetux-RT Although we did not complete full accrual, analysis of the six evaluable patients showed disappointing efficacy, as none of the resected tumors showed pCR. Previous studies with cetux-RT in patients with esophageal cancer did show an increase in pCR to Ecdysone 27%33% [24]. However, cetux-RT efficacy appears to be limited to squamous cell carcinomas [4, 5]. Since there were no preliminary indicators of efficacy, we feel that our study does not warrant further investigation of cetux-RT for resectable esophageal adenocarcinoma. Furthermore, since intensification of ECX will be problematic, option multimodality neoadjuvant schedules need to be identified. == Supplementary Material == Ecdysone == Footnotes == ClinicalTrials.govIdentifier:NCT00827671 Sponsor(s):University Medical Center Utrecht and Merck KGaA Principal Investigator:M.P. Lolkema IRB Approved:Yes == == Author disclosures and recommendations available online. == Associated Data == This section collects any data citations, data availability statements, or supplementary materials included in this article. == Supplementary Materials ==.