Table 2 Landmark studies of chemotherapy in the palliative settingAuthor
Experimental arm
Control arm
Outcomes
% of esophageal/esophagogastric junction adenocarcinoma
Subgroup outcomes
First lineREAL-2 (2008) [
29
]
ECF
ECXEOFEOX
Noninferiority*Improved OS of EOX over ECF upon
secondary analysis (HR 0.8,
p^ =
0.02)
Esophageal/esophagogastric junction ~60%Adenocarcinoma ~90%
NR
ML 17032 (2009) [
30
]
PX
PF
Noninferiority
NR
NR
SPIRITS (2008) [
34
]
SP
S-1
Improved OS (HR 0.77,
p^ =
0.04) and PFS
(6
months vs. 4
months,
p^ <
0.0001)
NR
NR
FLAGS (2010) [
35
]
SP
PF
Superiority in OS not demonstrated
17%
NR
AIO (2008) [
38
]
FLO
FLP
Noninferiority
Esophagogastric junction ~20%
NR
SOX (2015) [
39
]
SOX
SP
Noninferiority
NR
NR
V325 (2006) [
40
]
TPF
PF
Improved TTP (HR 0.68,
p^ <
0.001) and OS
(HR 0.77,
p^ =
0.02)
22%
NR
START (2013) [
44
]
TS
S-1
Improved OS and PFSmOS: 12.5
months vs. 10.8
months (
p^ =
0.032)
mPFS: 5.3
months vs. 4.2
months (
p^ =
0.001)
NR
NR
Dank et
al. (2008) [
45
]
IF
PF
Noninferiority
20%
NR
French Intergroup Study
(2014) [
46
]
FOLFIRI
ECX
Improved TTF and safety profileTTF: 5.1
months vs. 4.2
months,
p^ =
0.008
32.7%
NR
Second line or beyondThuss-Patience
et
al. (2011) [
47
]
Irinotecan
BSC
Improved OS (HR 0.48,
p^ =
0.012)
mOS: 4
months vs. 2.4
months
42%
NR
Kang et
al. (2012) [
50
]
Docetaxel or
Irinotecan
BSC
Improved OS (HR 0.66,
p^ =
0.007)
mOS: 5.3
months vs. 3.8
months
NR
NR
Ford et
al. (2014) [
48
]
Docetaxel
BSC
Improved OS (HR 0.67,
p^ =
0.01)
mOS: 5.2
months vs. 3.6
months
55%
NR
ECF
epirubicin, cisplatin and 5FU,
ECX
epirubicin, cisplatin and capecitabine,
EOF
epirubicin, oxaliplatin and 5FU,
EOX
epirubicin, oxaliplatin and capecitabine,
OS
overall survival,
NR
not reported,
PX
cispla-
tin and capecitabine,
PF
cisplatin and 5FU,
SP
S-1 and cisplatin,
PFS
progression-free survival,
FLO
5FU, leucovorin and oxaliplatin,
FLP
5FU, leucovorin and cisplatin,
SOX
S-1 and oxaliplatin,
TPF
docetaxel,
cisplatin and 5FU,
TTP
time-to-progression,
TS
docetaxel and S-1,
IF
irinotecan and 5FU,
FOLFIRI
irinotecan, leucovorin and 5FU,
TTF
time-to-treatment failure,
BSC
best supportive care