Response to neoadjuvant therapy in patients with oesophageal cancer
Research type
Research Study
Full title
Predicting the response to neoadjuvant therapy in patients with oesophageal cancer – collaboration with the OCCAMS/Edinburgh studies
IRAS ID
139550
Contact name
David Bunting
Contact email
Sponsor organisation
Plymouth Hospitals NHS Trust
Research summary
Can biomarkers be used to predict the response to pre-operative chemotherapy in patients with oesophageal cancer?
Outcomes from oesophageal cancer are poor. 5-year-survival ranges from 13% to 14%. Guidelines suggest all patients with potentially resectable disease are given preoperative chemotherapy or chemoradiotherapy in order to improve overall survival. Unfortunately, only patients achieving a complete or near-complete response to therapy (13-25%) will benefit from such treatment. The majority of patients will suffer the toxic effects and have a delay to surgery without any benefit from preoperative chemotherapy/chemoradiotherapy.
Authors have highlighted the need for predicting which patients will respond to preoperative therapy. Early assessment of the response, or better still pre-therapy prediction would enable non-responders to proceed directly to surgery or be considered for alternative therapies. Currently there are no accurate methods of predicting the response in clinical use.
Research to date indicates that the most predictive pre-therapy markers are likely to be biomarkers. A number of potential tissue markers have been identified but are subject to limitations. Potentially useful blood biomarkers have been identified including M2-pyruvate kinase, CEA, alkaline phosphatase, CA 19-9 and CA 74-2, although they have not as yet been adequately investigated.
The proposed study aims to investigate whether pre-therapy blood biomarker levels can be used to predict the response to preoperative chemotherapy/chemoradiotherapy, either alone or in combination with clinical/pathological data and radiological results.
Blood specimens taken and stored as part of two large UK research studies (the Oesophageal Cancer Clinical and Molecular Stratification Study and the Scottish Academic Health Sciences Collaboration BioResource) will be used in this study.
REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
13/EM/0437
Date of REC Opinion
13 Nov 2013
REC opinion
Favourable Opinion