PET-directed combined modality therapy for gastroesophageal junction cancer: Results of the multicentre prospective MEMORI trial of the German Cancer Consortium (DKTK)

Lorenzen, Sylvie; Quante, Michael; Rauscher, Isabel; Slotta-Huspenina, Julia; Weichert, Wilko; Feith, Marcus; Friess, Helmut; Combs, Stefanie E.; Weber, Wolfgang A.; Haller, Bernhard; Angele, Martin; Albertsmeier, Markus; Blankenstein, Christiane; Kasper, Stefan; Schmid, Roland M.; Bassermann, Florian; Schwaiger, Markus; Liffers, Sven-Thorsten und Siveke, Jens T. (2022): PET-directed combined modality therapy for gastroesophageal junction cancer: Results of the multicentre prospective MEMORI trial of the German Cancer Consortium (DKTK). In: European Journal of Cancer, Bd. 175: S. 99-106

Abstract

Background: Positron emission tomography (PET) may differentiate responding and non-responding tumours early in the treatment of locally advanced gastroesophageal junction adenocarcinomas. Early PET non-responders (P-NR) after induction CTX might benefit from changing to chemoradiation (CRT).Methods: Patients underwent baseline 18F-FDG PET followed by 1 cycle of CTX. PET was repeated at day 14-21 and responders (P-R), defined as >_35% decrease in SUVmean from base-line, continued with CTX. P-NR switched to CRT (CROSS). Patients underwent surgery 4-6 weeks post-CTX/CRT. The primary objective was an improvement in R0 resection rates in P -NR above a proportion of 70%.Results: In total, 160 patients with resectable gastroesophageal junction adenocarcinomas were prospectively investigated by PET scanning. Eighty-five patients (53%) were excluded. Seventy-five eligible patients were enrolled in the study. Based on PET criteria, 50 (67.6%)/ 24 (32.4%) were P-R and P-NR, respectively. Resection was performed on 46 responders, including one patient who withdrew the ICF, and 22 non-responders (per-protocol popula-tion). R0 resection rates were 95.6% (43/45) for P-R and 86.4% (19/22) for P-NR. No treat-ment related deaths occurred. With a median follow-up time of 24.5 months, estimated 18 months DFS was 75.4%/64.2% for P-R/P-NR, respectively. The estimated 18 months OS was 95.5% for P-R and 68.2% for P-NR.Conclusion: The primary endpoint of the study to increase the R0 resection rate in metabolic NR was not met. PET response after induction CTX is prognostic for outcome with a pro-longed OS and DFS in PET responders.Trial registration: NCT 2014-000860-16.(c) 2022 Elsevier Ltd. All rights reserved.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0959-8049
• Sprache: Englisch