Individual Participant Data Network Meta-Analysis of Neoadjuvant Chemotherapy or Chemoradiotherapy in Esophageal or Gastroesophageal Junction Carcinoma
Matthieu Faron
(1, 2)
,
Maurice Cheugoua-Zanetsie
(1, 3, 4, 2)
,
Jayne Tierney
,
Pierre Thirion
,
Matthew Nankivell
,
Kathryn Winter
,
Hong Yang
,
Joel Shapiro
,
Dewi Vernerey
,
B. Mark Smithers
,
Thomas Walsh
,
Guillaume Piessen
,
Magnus Nilsson
,
Jurjen Boonstra
,
Marc Ychou
,
Simon Law
,
David Cunningham
,
Florent de Vathaire
(5)
,
Michael Stahl
,
Susan Urba
,
Michele Valmasoni
,
Danièle Williaume
,
Janine Thomas
,
Florian Lordick
,
Joel Tepper
,
Jack Roth
,
Val Gebski
,
Bryan Burmeister
,
Xavier Paoletti
,
Johanna van Sandick
,
Jianhua Fu
,
Jean-Pierre Pignon
(1, 3, 4)
,
Michel Ducreux
,
Stefan Michiels
(2, 3, 1, 6, 4)
,
Chanvitan Apinop
,
Anne Arezina
,
Emilie Barbier
,
Gary Bass
,
Pierre Blanchard
(1, 2)
,
Jurjen Boonstra
,
Jean-François Bosset
,
Bryan Burmeister
,
Armel Maurice Cheugoua-Zanetsie
(1)
,
David Cunningham
,
Michel Ducreux
,
Matthieu Faron
(1)
,
Jianhua Fu
,
Val Gebski
,
D. Girling
,
David Kelsen
,
Fredrik Klevebro
,
Simon Law
,
Elisabeth Le Prise
,
Florian Lordick
,
Tanaphon Maipang
,
Murielle Mauer
,
Stefan Michiels
(1)
,
Jennifer Moughan
,
Matthew Nankivell
,
Knut Nygaard
,
Patrick Owens
,
Xavier Paoletti
,
Guillaume Piessen
,
Jean Pierre Pignon
(1)
,
Jean-Luc Raoul
,
Jack Roth
,
Alberto Ruol
,
Peter Schlag
,
Christoph Schumacher
,
Joel Shapiro
,
B. Mark Smithers
,
Michael Stahl
,
Joel Tepper
,
Pierre Thirion
,
Janine Thomas
,
Jayne Tierney
,
Susan Urba
,
Michele Valmasoni
,
Ate van der Gaast
,
Johanna van Sandick
,
Danièle Williaume
,
Kathryn Winter
,
John Wong
,
Hong Yang
,
Marc Ychou
Matthieu Faron
- Function : Author
- PersonId : 1297171
- ORCID : 0000-0003-2331-0792
Maurice Cheugoua-Zanetsie
- Function : Author
- PersonId : 1297172
- ORCID : 0000-0002-9447-4631
Jayne Tierney
- Function : Author
Pierre Thirion
- Function : Author
Matthew Nankivell
- Function : Author
- PersonId : 1297173
- ORCID : 0000-0003-3904-2729
Kathryn Winter
- Function : Author
Hong Yang
- Function : Author
- PersonId : 1297174
- ORCID : 0000-0003-0824-0511
Joel Shapiro
- Function : Author
- PersonId : 1297175
- ORCID : 0000-0002-6552-4281
Dewi Vernerey
- Function : Author
B. Mark Smithers
- Function : Author
Thomas Walsh
- Function : Author
Guillaume Piessen
- Function : Author
- PersonId : 1297176
- ORCID : 0000-0001-8243-8310
Magnus Nilsson
- Function : Author
Jurjen Boonstra
- Function : Author
- PersonId : 1297177
- ORCID : 0000-0002-8221-9158
Marc Ychou
- Function : Author
Simon Law
- Function : Author
David Cunningham
- Function : Author
- PersonId : 1297178
- ORCID : 0000-0001-5158-1069
Florent de Vathaire
- Function : Author
- PersonId : 1162629
- IdHAL : florent-de-vathaire
- ORCID : 0000-0002-8374-9281
Michael Stahl
- Function : Author
Susan Urba
- Function : Author
Michele Valmasoni
- Function : Author
- PersonId : 1297179
- ORCID : 0000-0002-1462-8275
Danièle Williaume
- Function : Author
Janine Thomas
- Function : Author
Florian Lordick
- Function : Author
Joel Tepper
- Function : Author
- PersonId : 1297180
- ORCID : 0000-0002-8591-4228
Jack Roth
- Function : Author
Val Gebski
- Function : Author
- PersonId : 1297181
- ORCID : 0000-0001-8748-1844
Bryan Burmeister
- Function : Author
Xavier Paoletti
- Function : Author
- PersonId : 799966
- ORCID : 0000-0002-1250-0040
Johanna van Sandick
- Function : Author
Jianhua Fu
- Function : Author
- PersonId : 1297182
- ORCID : 0000-0003-2458-2562
Jean-Pierre Pignon
- Function : Author
- PersonId : 1260601
- ORCID : 0000-0003-2047-1582
Michel Ducreux
- Function : Author
Stefan Michiels
- Function : Author
- PersonId : 759812
- IdHAL : stefan-michiels
- ORCID : 0000-0002-6963-2968
- IdRef : 129474622
Chanvitan Apinop
- Function : Author
Anne Arezina
- Function : Author
Emilie Barbier
- Function : Author
Gary Bass
- Function : Author
Jurjen Boonstra
- Function : Author
Jean-François Bosset
- Function : Author
Bryan Burmeister
- Function : Author
David Cunningham
- Function : Author
Michel Ducreux
- Function : Author
Jianhua Fu
- Function : Author
Val Gebski
- Function : Author
D. Girling
- Function : Author
David Kelsen
- Function : Author
Fredrik Klevebro
- Function : Author
Simon Law
- Function : Author
Elisabeth Le Prise
- Function : Author
Florian Lordick
- Function : Author
Tanaphon Maipang
- Function : Author
Murielle Mauer
- Function : Author
Jennifer Moughan
- Function : Author
Matthew Nankivell
- Function : Author
Knut Nygaard
- Function : Author
Patrick Owens
- Function : Author
Xavier Paoletti
- Function : Author
Guillaume Piessen
- Function : Author
Jean-Luc Raoul
- Function : Author
Jack Roth
- Function : Author
Alberto Ruol
- Function : Author
Peter Schlag
- Function : Author
Christoph Schumacher
- Function : Author
Joel Shapiro
- Function : Author
B. Mark Smithers
- Function : Author
Michael Stahl
- Function : Author
Joel Tepper
- Function : Author
Pierre Thirion
- Function : Author
Janine Thomas
- Function : Author
Jayne Tierney
- Function : Author
Susan Urba
- Function : Author
Michele Valmasoni
- Function : Author
Ate van der Gaast
- Function : Author
Johanna van Sandick
- Function : Author
Danièle Williaume
- Function : Author
Kathryn Winter
- Function : Author
John Wong
- Function : Author
Hong Yang
- Function : Author
Marc Ychou
- Function : Author
Abstract
PURPOSE The optimal neoadjuvant treatment for resectable carcinoma of the thoracic esophagus (TE) or gastroesophageal junction (GEJ) remains a matter of debate. We performed an individual participant data (IPD) network meta-analysis (NMA) of randomized controlled trials (RCTs) to study the effect of chemotherapy or chemoradiotherapy, with a focus on tumor location and histology subgroups. PATIENTS AND METHODS All, published or unpublished, RCTs closed to accrual before December 31, 2015 and having compared at least two of the following strategies were eligible: upfront surgery (S), chemotherapy followed by surgery (CS), and chemoradiotherapy followed by surgery (CRS). All analyses were conducted on IPD obtained from investigators. The primary end point was overall survival (OS). The IPD-NMA was analyzed by a one-step mixed-effect Cox model adjusted for age, sex, tumor location, and histology. The NMA was registered in PROSPERO (CRD42018107158). RESULTS IPD were obtained for 26 of 35 RCTs (4,985 of 5,807 patients) corresponding to 12 comparisons for CS-S, 12 for CRS-S, and four for CRS-CS. CS and CRS led to increased OS when compared with S with hazard ratio (HR) = 0.86 (0.75 to 0.99), P = .03 and HR = 0.77 (0.68 to 0.87), P < .001 respectively. The NMA comparison of CRS versus CS for OS gave a HR of 0.90 (0.74 to 1.09), P = .27 (consistency P = .26, heterogeneity P = .0038). For CS versus S, a larger effect on OS was observed for GEJ versus TE tumors ( P = .036). For the CRS versus S and CRS versus CS, a larger effect on OS was observed for women ( P = .003, .012, respectively). CONCLUSION Neoadjuvant chemotherapy and chemoradiotherapy were consistently better than S alone across histology, but with some variation in the magnitude of treatment effect by sex for CRS and tumor location for CS. A strong OS difference between CS and CRS was not identified.
Domains
Life Sciences [q-bio]
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Origin : Publication funded by an institution