Preoperative taxane-based chemotherapy and celecoxib for carcinoma of the esophagus and gastroesophageal junction: Results of a phase 2 trial

Nasser K. Altorki, Paul Christos, Jeff L. Port, Paul C. Lee, Farooq Mirza, Cathy Spinelli, Roger Keresztes, Debra Beneck, Subroto Paul, Brendon M. Stiles, Yuwei Zhang, David S. Schrump

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Purpose: The primary objective of this study was to determine the rate of pathological response after preoperative celecoxib and concurrent taxane-based chemotherapy in patients with cancer of the esophagus and gastroesophageal junction. Methods: Thirty-nine patients were enrolled in this single-arm, phase II clinical trial. Patients were administered daily celecoxib in combination with two to three cycles of carboplatin and paclitaxel with preoperative intent. Levels of cyclooxygenase (COX)-2 expression in resected tumors were analyzed by immunohistochemistry and correlated with clinical outcome measures. Postoperatively, patients were administered daily celecoxib for 1 year or until documented tumor recurrence. Results: All patients received two to three cycles of chemotherapy plus celecoxib 800 mg/d. Toxicities were as expected. A major clinical response (complete response + partial response) was noted in 22 patients (56%); six patients (15%) had a complete clinical response. Thirty-seven patients underwent esophagectomy. Five patients had a major pathological response (12.8%). Four-year overall and disease-free survivals were 40.9% and 30.3%, respectively. Patients with tumors expressing COX-2 demonstrated a higher likelihood of a major clinical response response (62% versus 50%) and an improved overall survival, compared with patients with COX-2-negative tumors. Conclusions: Preoperative celecoxib with concurrent chemotherapy demonstrated sufficient effect on pathologic response to warrant further study. Patients with tumors expressing COX-2 demonstrated trends toward improved response to preoperative therapy and improved overall survival compared with nonexpressors.

Original languageEnglish (US)
Pages (from-to)1121-1127
Number of pages7
JournalJournal of Thoracic Oncology
Volume6
Issue number6
DOIs
StatePublished - Jun 2011
Externally publishedYes

Keywords

  • Celecoxib
  • COX-2
  • Esophageal cancer

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

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