Real-world outcomes of the CROSS regimen in patients with resectable esophageal or gastro-esophageal junction adenocarcinoma: a nationwide cohort study in the NetherlandsResearch in context
Summary: Background: Recent studies in patients with resectable adenocarcinoma of the esophagus or gastroesophageal junction (GEJ)—Neo-AEGIS and ESOPEC—have explored the comparison of neoadjuvant chemoradiotherapy (nCRT) with chemotherapy, with conflicting results. To contextualize the findings fro...
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Elsevier
2025-02-01
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| Series: | EClinicalMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537024006461 |
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| author | Hanneke van Laarhoven Rob Verhoeven Mark van Berge Henegouwen Nadia Haj Mohammad Richard van Hillegersberg Marije Slingerland Christina T. Muijs Bas Wijnhoven Bianca Mostert Laurens Beerepoot Grard Nieuwenhuijzen Sarah Derks Peter S.N. van Rossum |
| author_facet | Hanneke van Laarhoven Rob Verhoeven Mark van Berge Henegouwen Nadia Haj Mohammad Richard van Hillegersberg Marije Slingerland Christina T. Muijs Bas Wijnhoven Bianca Mostert Laurens Beerepoot Grard Nieuwenhuijzen Sarah Derks Peter S.N. van Rossum |
| author_sort | Hanneke van Laarhoven |
| collection | DOAJ |
| description | Summary: Background: Recent studies in patients with resectable adenocarcinoma of the esophagus or gastroesophageal junction (GEJ)—Neo-AEGIS and ESOPEC—have explored the comparison of neoadjuvant chemoradiotherapy (nCRT) with chemotherapy, with conflicting results. To contextualize the findings from these studies using nCRT as a comparator, we aimed to investigate contemporary real-world outcomes of nCRT in patients with adenocarcinoma of the esophagus or GEJ. Methods: From the Netherlands Cancer Registry, patients were selected who were diagnosed between 1 January 2015 and 31 December 2022 with a resectable (cT1N+M0 or cT2-4aNanyM0) esophageal, GEJ or gastric cardia adenocarcinoma and started treatment with nCRT according to the CROSS regimen, that is 5 weekly cycles of carboplatin (AUC 2 mg/mL per minute) and paclitaxel (50 mg/m2) combined with concurrent radiotherapy (41.4 Gy in 23 fractions of 1.8 Gy). Pathologic complete response (pCR) according to Mandard was the primary outcome of this study and defined as complete tumor regression of the primary tumor (Mandard grade I) irrespective of residual nodal involvement. Findings: Of the 4765 included patients, 4170 (87.5%) completed the full CROSS regimen of radiotherapy and chemotherapy. A pCR was observed in 704 (20.5%) of 3439 patients who underwent surgical resection within 16 weeks after completing the CROSS regimen. In the complete study population, the median overall survival (OS) was 33.7 months (95% CI 32.0–35.6), with a 3-year OS rate of 48.1%. Interpretation: Although survival rates in real-world settings are often lower compared to clinical trials, in our real-world cohort the 3-year OS was only 2.6% lower compared to that reported for the group that underwent nCRT in ESOPEC. These real-world results underscore the potential of the CROSS regimen in daily clinical practice. Funding: None. |
| format | Article |
| id | doaj-art-a53138aabef44282977d47c293016bd5 |
| institution | Kabale University |
| issn | 2589-5370 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj-art-a53138aabef44282977d47c293016bd52025-01-24T04:45:35ZengElsevierEClinicalMedicine2589-53702025-02-0180103067Real-world outcomes of the CROSS regimen in patients with resectable esophageal or gastro-esophageal junction adenocarcinoma: a nationwide cohort study in the NetherlandsResearch in contextHanneke van Laarhoven0Rob Verhoeven1Mark van Berge Henegouwen2Nadia Haj Mohammad3Richard van Hillegersberg4Marije Slingerland5Christina T. Muijs6Bas Wijnhoven7Bianca Mostert8Laurens Beerepoot9Grard Nieuwenhuijzen10Sarah Derks11Peter S.N. van Rossum12Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, AZ, 1105, the Netherlands; Cancer Center Amsterdam, Cancer Treatment & Quality of Life, Amsterdam, the Netherlands; Corresponding author. Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, AZ, 1105, the Netherlands.Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, AZ, 1105, the Netherlands; Cancer Center Amsterdam, Cancer Treatment & Quality of Life, Amsterdam, the Netherlands; Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the NetherlandsCancer Center Amsterdam, Cancer Treatment & Quality of Life, Amsterdam, the Netherlands; Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, AZ, 1105, the NetherlandsDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the NetherlandsDepartment of Surgery, University Medical Center Utrecht, Utrecht, the NetherlandsDepartment of Medical Oncology, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Radiation Oncology, University Medical Center Groningen, Groningen, the NetherlandsDivision of Surgical Oncology and Gastrointestinal Surgery, Department of Surgery, Erasmus MC Cancer Institute University Medical Center, Rotterdam, the NetherlandsDepartment of Medical Oncology, Erasmus MC Cancer Institute University Medical Center, Rotterdam, the NetherlandsDepartment of Medical Oncology, Elisabeth-Tweesteden Hospital, Tilburg, the NetherlandsDepartment of Surgery, Catharina Hospital, Eindhoven, NetherlandsCancer Center Amsterdam, Cancer Treatment & Quality of Life, Amsterdam, the Netherlands; Department of Medical Oncology, Amsterdam UMC Location Free University, Amsterdam, the NetherlandsCancer Center Amsterdam, Cancer Treatment & Quality of Life, Amsterdam, the Netherlands; Department of Radiation Oncology, Amsterdam UMC Location Free University Amsterdam, Amsterdam, the NetherlandsSummary: Background: Recent studies in patients with resectable adenocarcinoma of the esophagus or gastroesophageal junction (GEJ)—Neo-AEGIS and ESOPEC—have explored the comparison of neoadjuvant chemoradiotherapy (nCRT) with chemotherapy, with conflicting results. To contextualize the findings from these studies using nCRT as a comparator, we aimed to investigate contemporary real-world outcomes of nCRT in patients with adenocarcinoma of the esophagus or GEJ. Methods: From the Netherlands Cancer Registry, patients were selected who were diagnosed between 1 January 2015 and 31 December 2022 with a resectable (cT1N+M0 or cT2-4aNanyM0) esophageal, GEJ or gastric cardia adenocarcinoma and started treatment with nCRT according to the CROSS regimen, that is 5 weekly cycles of carboplatin (AUC 2 mg/mL per minute) and paclitaxel (50 mg/m2) combined with concurrent radiotherapy (41.4 Gy in 23 fractions of 1.8 Gy). Pathologic complete response (pCR) according to Mandard was the primary outcome of this study and defined as complete tumor regression of the primary tumor (Mandard grade I) irrespective of residual nodal involvement. Findings: Of the 4765 included patients, 4170 (87.5%) completed the full CROSS regimen of radiotherapy and chemotherapy. A pCR was observed in 704 (20.5%) of 3439 patients who underwent surgical resection within 16 weeks after completing the CROSS regimen. In the complete study population, the median overall survival (OS) was 33.7 months (95% CI 32.0–35.6), with a 3-year OS rate of 48.1%. Interpretation: Although survival rates in real-world settings are often lower compared to clinical trials, in our real-world cohort the 3-year OS was only 2.6% lower compared to that reported for the group that underwent nCRT in ESOPEC. These real-world results underscore the potential of the CROSS regimen in daily clinical practice. Funding: None.http://www.sciencedirect.com/science/article/pii/S2589537024006461Esophageal adenocarcinomaNeoadjuvant chemoradiotherapyPathological complete responseOverall survivalReal-world data |
| spellingShingle | Hanneke van Laarhoven Rob Verhoeven Mark van Berge Henegouwen Nadia Haj Mohammad Richard van Hillegersberg Marije Slingerland Christina T. Muijs Bas Wijnhoven Bianca Mostert Laurens Beerepoot Grard Nieuwenhuijzen Sarah Derks Peter S.N. van Rossum Real-world outcomes of the CROSS regimen in patients with resectable esophageal or gastro-esophageal junction adenocarcinoma: a nationwide cohort study in the NetherlandsResearch in context EClinicalMedicine Esophageal adenocarcinoma Neoadjuvant chemoradiotherapy Pathological complete response Overall survival Real-world data |
| title | Real-world outcomes of the CROSS regimen in patients with resectable esophageal or gastro-esophageal junction adenocarcinoma: a nationwide cohort study in the NetherlandsResearch in context |
| title_full | Real-world outcomes of the CROSS regimen in patients with resectable esophageal or gastro-esophageal junction adenocarcinoma: a nationwide cohort study in the NetherlandsResearch in context |
| title_fullStr | Real-world outcomes of the CROSS regimen in patients with resectable esophageal or gastro-esophageal junction adenocarcinoma: a nationwide cohort study in the NetherlandsResearch in context |
| title_full_unstemmed | Real-world outcomes of the CROSS regimen in patients with resectable esophageal or gastro-esophageal junction adenocarcinoma: a nationwide cohort study in the NetherlandsResearch in context |
| title_short | Real-world outcomes of the CROSS regimen in patients with resectable esophageal or gastro-esophageal junction adenocarcinoma: a nationwide cohort study in the NetherlandsResearch in context |
| title_sort | real world outcomes of the cross regimen in patients with resectable esophageal or gastro esophageal junction adenocarcinoma a nationwide cohort study in the netherlandsresearch in context |
| topic | Esophageal adenocarcinoma Neoadjuvant chemoradiotherapy Pathological complete response Overall survival Real-world data |
| url | http://www.sciencedirect.com/science/article/pii/S2589537024006461 |
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