TY - JOUR
T1 - ICORG 10-14
T2 - NEOadjuvant trial in Adenocarcinoma of the oEsophagus and oesophagoGastric junction International Study (Neo-AEGIS)
AU - Reynolds, J V
AU - Preston, S R
AU - O'Neill, B
AU - Baeksgaard, L
AU - Griffin, S M
AU - Mariette, C
AU - Cuffe, S
AU - Cunningham, M
AU - Crosby, T
AU - Parker, I
AU - Hofland, K
AU - Hanna, G
AU - Svendsen, L B
AU - Donohoe, C L
AU - Muldoon, C
AU - O'Toole, D
AU - Johnson, C
AU - Ravi, N
AU - Jones, G
AU - Corkhill, A K
AU - Illsley, M
AU - Mellor, J
AU - Lee, K
AU - Dib, M
AU - Marchesin, V
AU - Cunnane, M
AU - Scott, K
AU - Lawner, P
AU - Warren, S
AU - O'Reilly, S
AU - O'Dowd, G
AU - Leonard, G
AU - Hennessy, B
AU - Dermott, R Mc
PY - 2017/6/3
Y1 - 2017/6/3
N2 - BACKGROUND: Neoadjuvant therapy is increasingly the standard of care in the management of locally advanced adenocarcinoma of the oesophagus and junction (AEG). In randomised controlled trials (RCTs), the MAGIC regimen of pre- and postoperative chemotherapy, and the CROSS regimen of preoperative chemotherapy combined with radiation, were superior to surgery only in RCTs that included AEG but were not powered on this cohort. No completed RCT has directly compared neoadjuvant or perioperative chemotherapy and neoadjuvant chemoradiation. The Neo-AEGIS trial, uniquely powered on AEG, and including comprehensive modern staging, compares both these regimens.METHODS: This open label, multicentre, phase III RCT randomises patients (cT2-3, N0-3, M0) in a 1:1 fashion to receive CROSS protocol (Carboplatin and Paclitaxel with concurrent radiotherapy, 41.4Gy/23Fr, over 5 weeks). The power calculation is a 10% difference in favour of CROSS, powered at 80%, two-sided alpha level of 0.05, requiring 540 patients to be evaluable, 594 to be recruited if a 10% dropout is included (297 in each group). The primary endpoint is overall survival, with a minimum 3-year follow up. Secondary endpoints include: disease free survival, recurrence rates, clinical and pathological response rates, toxicities of induction regimens, post-operative pathology and tumour regression grade, operative in-hospital complications, and health-related quality of life. The trial also affords opportunities for establishing a bio-resource of pre-treatment and resected tumour, and translational research.DISCUSSION: This RCT directly compares two established treatment regimens, and addresses whether radiation therapy positively impacts on overall survival compared with a standard perioperative chemotherapy regimen Sponsor: Irish Clinical Research Group (ICORG).TRIAL REGISTRATION: NCT01726452 . Protocol 10-14. Date of registration 06/11/2012.
AB - BACKGROUND: Neoadjuvant therapy is increasingly the standard of care in the management of locally advanced adenocarcinoma of the oesophagus and junction (AEG). In randomised controlled trials (RCTs), the MAGIC regimen of pre- and postoperative chemotherapy, and the CROSS regimen of preoperative chemotherapy combined with radiation, were superior to surgery only in RCTs that included AEG but were not powered on this cohort. No completed RCT has directly compared neoadjuvant or perioperative chemotherapy and neoadjuvant chemoradiation. The Neo-AEGIS trial, uniquely powered on AEG, and including comprehensive modern staging, compares both these regimens.METHODS: This open label, multicentre, phase III RCT randomises patients (cT2-3, N0-3, M0) in a 1:1 fashion to receive CROSS protocol (Carboplatin and Paclitaxel with concurrent radiotherapy, 41.4Gy/23Fr, over 5 weeks). The power calculation is a 10% difference in favour of CROSS, powered at 80%, two-sided alpha level of 0.05, requiring 540 patients to be evaluable, 594 to be recruited if a 10% dropout is included (297 in each group). The primary endpoint is overall survival, with a minimum 3-year follow up. Secondary endpoints include: disease free survival, recurrence rates, clinical and pathological response rates, toxicities of induction regimens, post-operative pathology and tumour regression grade, operative in-hospital complications, and health-related quality of life. The trial also affords opportunities for establishing a bio-resource of pre-treatment and resected tumour, and translational research.DISCUSSION: This RCT directly compares two established treatment regimens, and addresses whether radiation therapy positively impacts on overall survival compared with a standard perioperative chemotherapy regimen Sponsor: Irish Clinical Research Group (ICORG).TRIAL REGISTRATION: NCT01726452 . Protocol 10-14. Date of registration 06/11/2012.
KW - Adenocarcinoma/drug therapy
KW - Adult
KW - Aged
KW - Antineoplastic Combined Chemotherapy Protocols/administration & dosage
KW - Carboplatin/administration & dosage
KW - Disease-Free Survival
KW - Esophageal Neoplasms/drug therapy
KW - Esophagogastric Junction/drug effects
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoadjuvant Therapy
KW - Neoplasm Recurrence, Local/drug therapy
KW - Paclitaxel/administration & dosage
KW - Quality of Life
U2 - 10.1186/s12885-017-3386-2
DO - 10.1186/s12885-017-3386-2
M3 - Journal article
C2 - 28578652
SN - 1471-2407
VL - 17
JO - B M C Cancer
JF - B M C Cancer
M1 - 401
ER -