Oesophageal Cancer: Pre-Operative Chemotherapy Benefits “More Patients Than Previously Thought”

Giving pre-operative chemotherapy during the treatment of oesophageal cancer confers a survival benefit in more patients than previously thought, according to recent research.  Scientists and doctors at the University of Southampton examined the records of 218 patients treated between 2005 and 2011 and found that giving chemotherapy prior to surgery delayed cancer recurrence.

Although pre-operative chemotherapy is recommended as standard for oesophageal cancer, few studies have investigated which patients are most likely to benefit.  This research, published in the World Journal of Gastroenterology, confirmed that the 26% of patients whose tumours responded to chemotherapy experienced extended disease free survival.  However, the analysis also revealed a second smaller group who benefited; although their primary tumours failed to respond, chemotherapy reduced the spread of disease to lymph nodes.  This translated to a striking survival benefit; the average time to recurrence was extended from just over one year to five and a half years.

Mr Tim Underwood, a clinical scientist who worked on the study, commented that “more patients than previously thought do benefit from chemotherapy before surgery, which means that having more treatment after their operation might also work for them.”  The research is an important step because, besides informing current treatment options, it will also act as a springboard for further studies aimed at understanding why some patients benefit from chemotherapy more than others.

The race is now on to identify novel biomarkers which will allow treatment plans to be tailored to patients’ needs. Toward this end, scientists including Mr Underwood are working to understand the genetics of oesophageal cancer as part of a worldwide effort.  With the incidence of oesophageal cancer rising and survival rates remaining poor, it is hoped that this work will provide a turning point for improving our understanding of this devastating disease.