The Benefit of Taxane-based Therapies over Fluoropyrimidine Plus Platinum (FP) in the Treatment of Esophageal Cancer: a Meta-analysis of Clinical Studies

Overview

Journal Drug Des Devel Ther

Specialty Pharmacology

Date 2019 Feb 22

PMID 30787595

Citations 12

Authors

Tao Wang

Jie Yu

Min Liu

Yanliang Chen

Caiyun Zhu

Lin Lu

Mingzhu Wang

Lingfeng Min

Xinxin Liu

Xizhi Zhang

Johannes A Gubat

Yong Chen

Affiliations

Soon will be listed here.

Abstract

Purpose: Fluoropyrimidine plus platinum (FP) is currently the standard treatment for esophageal cancer (EC). In recent years, taxane-based chemotherapy has also been used and has shown good efficacy in EC. This study aims to investigate the advantages of taxane-based over FP chemotherapy, as well as discuss its drawbacks, in the treatment of EC.

Patients And Methods: A literature search was done for studies comparing clinical outcomes between taxane-based and FP chemotherapy in EC. Pooled analyses were performed to compare the efficacy and grade 3/4 adverse events in patients who received neoadjuvant chemotherapy (NACT), neoadjuvant chemoradiotherapy (NACRT), or definitive chemoradiotherapy (dCRT). Subgroup analyses were also conducted in esophageal squamous cell carcinoma (ESCC).

Results: Thirty-one studies with a total of 3,912 patients were included in the analysis. Better long-term survival was found in patients who received taxane-based NACT (progression-free survival (PFS): pooled HR=0.58, =0.0008; and overall survival (OS): pooled HR=0.50, <0.00001) and dCRT (PFS: pooled HR=0.75, <0.0001). In NACRT, taxane-based treatment and FP showed similar efficacy. In ESCC patients, taxane-based treatment showed better OS (NACT: pooled HR=0.57, =0.02; NACRT: pooled HR=0.51, =0.03; and dCRT: pooled HR=0.73, <0.0001) than FP chemotherapy. Furthermore, taxane-based therapy also showed a better short-term response (complete response (CR), objective response rate (ORR), disease control rate (DCR), or pathologic complete response (pCR). However, taxane-based therapy was significantly correlated with a higher incidence of grade 3/4 leukopenia, neutropenia, and diarrhea.

Conclusion: Compared to FP, taxane-based therapy produced better clinical response and outcomes in EC patients receiving NACT or dCRT, and in all types of therapy in patients with ESCC. Taxane-based treatment is associated with more frequent toxicity.

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