Neoadjuvant therapy for gastroesophageal adenocarcinoma

Table 1 Two neoadjuvant chemotherapy schedules offered for the treatment of resectable gastroesophageal adenocarcinomas

	MAGIC[24]			FNCLCC-FFCD[27]
	ECFn = 250	Surgeryn = 253	P	FPn = 113	Surgeryn = 111	P
Median age, yr (range)	62 (29-85)	62 (23-81)		63 (36-75)	63 (38-75)
Sex, male (%)	82%	76%		85%	82%
Performance status, 0/1	68/32	68/32		74/26	75/25
Gastric ADK (%)	74%	74%		25%	24%
GOJ ADK (%)	26%	26%		75%	76%
Downstaging/downsizing (%)
T1/T2	52%	38%	0.09	42%	32%	0.16
T3/T4	48%	62%		58%	68%
N0/N1	84%	76%	0.01	(N0) 33%	20%	0.54
N2/N3	16%	29%		(N+) 67%	80%
R0 resection rate (%)	79%	70%	0.03	84%	73%	0.04
5-yr overall survival rate (%)	36%	23%	0.009 (HR = 0.75)	38%	24%	0.002 (HR = 0.69)

ADK: Adenocarcinomas; GOJ: Gastro-esophageal junction; ECF: Epirubicin, cisplatin and 5-FU; FP: 5-fluorouracil and cisplatin; MAGIC: Medical research council; FNCLCC-FFCD: Fédération nationale des centres de lutte contre le cancer - fédération française de cancérologie digestive.

Table 2 Neoadjuvant chemoradiotherapy schedule offered in the treatment of resectable gastroesophageal junction and lower esophagus adenocarcinomas

Trials	Patients (n)	Pathology	CT-RT	5-yr OS rate (%)
Walsh 1996	CT-RT = 58 S = 55	ADK (100%)	CDDP-5FU 40 Gy	CT-RT 32% S 6% (3-yr OS) (P = 0.01)
Urba 2001	CT-RT = 50 S = 50	ADK (75%) SCC	CDDP-VLB-5FU 45 Gy	CT-RT 30% S 16% (3-yr S) (P = 0.15)
Burmeister 2005	CT-RT = 128 S = 128	ADK (62%) SCC	CDDP-5FU 35 Gy	CT-RT 22 mo S 19 mo (P = 0.38)
Tepper 2008	CT-RT = 30 S = 26	ADK (75%) SCC	CDDP-5FU 50.4 Gy	CT-RT 39% S 16% (P < 0.008)
CROSS 2010	CT-RT = 180 S = 188	ADK (75%) SCC	Paclitaxel-carboplatin 41.4 Gy	CT-RT 47% S 34% (P = 0.03)

CT-RT: Chemoradiotherapy; OS: Overall survival; S: Surgery; ADK: Adenocarcinoma; SCC: Squamous cell carcinoma; VLB: Vinblastin.