From January 20th through the 22nd, 2022, researchers, specialists, and other stakeholders descended on the Gastrointestinal Cancers Symposium to discuss new and innovative research on gastrointestinal cancers. During the Symposium, one set of researchers highlighted data from a Phase 3 clinical trial evaluating docetaxel for esophageal cancer. In particular, the research centered around adding docetaxel to 5-FU and cisplatin chemotherapy for those with esophageal squamous cell cancer. 

According to Healio, findings from the JCOG9907 study highlight the safety, efficacy, and tolerability of docetaxel as neoadjuvant therapy. In addition to being relatively safe and well-tolerated, the treatment also significantly improved overall survival rates. 

About the JCOG9907 Trial

During the trial, researchers evaluated docetaxel in conjunction with cisplatin and 5-FU chemotherapy for esophageal cancer. Docetaxel is an intravenously administered chemotherapy drug which is currently approved to treat breast cancer, metastatic prostate cancer, head and neck cancer, advanced stomach cancer, and non-small cell lung cancer (NSCLC). Learn more about docetaxel here. 

Researchers also evaluated the efficacy of radiotherapy in conjunction with cisplatin and 5-FU chemotherapy. 

Altogether, 601 patients (a majority of whom were male) enrolled in the study. Participants either received neoadjuvant cisplatin and 5-FU chemotherapy; radiotherapy, cisplatin, and 5-FU chemotherapy; or docetaxel, cisplatin, and 5-FU chemotherapy. 

Ultimately, researchers found that those treated with docetaxel had significantly higher overall survival rates. For example, this group had a 3-year survival rate of 72.1%. This same group also saw longer periods of progression-free survival. Although the treatment was relatively safe and well-tolerated, some adverse reactions did occur, including esophagitis and febrile neutropenia. Finally, researchers also determined that docetaxel did not heighten the risk of complications during surgical interventions.

Alternately, adding radiotherapy to the chemotherapy did not significantly improve or alter overall survival. Thus, researchers believe that neoadjuvant docetaxel with cisplatin and 5-FU chemotherapy could be a better and more effective standard of care for those with advanced esophageal cancer. 

Esophageal Cancer

As the name suggests, esophageal cancer begins in esophageal tissue. Our esophagus runs from the throat to the stomach, helping move food to be digested. In esophageal cancer, the cancerous cells usually form in the esophageal lining before spreading to outer esophageal layers. There are multiple subtypes of esophageal cancer, including esophageal sarcoma or lymphoma, adenocarcinoma, or squamous cell carcinoma. Overall, esophageal squamous cell carcinoma is the most common subtype. Risk factors include being male, smoking cigarettes, consuming alcohol, being obese, or having acid reflux. In early stages, this cancer is usually asymptomatic. As symptoms appear, they include:

• Progressively worsening heartburn or indigestion
• Chronic cough
• Chest pain or pressure
• Unintended weight loss
• Painful or difficult swallowing 
• Esophageal obstruction
• Hoarse voice
• Bone pain

Learn more about esophageal cancer.