Abstract 813: A combination of cisplatin, irinotecan, and paclitaxel (CIP) as frontline treatment of patients with metastatic esophageal cancer (mEC)

Introduction: Median survival associated with mEC is 9-12 months. While systemic therapy is the mainstay of treatment for mEC, there is no consensus regarding the best frontline chemotherapy combination. We evaluated the efficacy of CIP (Cisplatin 30 mg/m2, Irinotecan 50 mg/m2 and Paclitaxel 50 mg/m2 on days 1 and 8 of a 21 day cycle) in patients with mEC. Methods: We performed a retrospective review to identify mEC patients at the Medical College of Wisconsin (MCW) who were treated with frontline CIP between January 1, 2005 and December 31, 2010. Relevant clinical information was collected through a review of the electronic medical record. This study was approved by the Institutional Review Board at MCW. Results: We identified 13 patients who were treated with CIP as frontline therapy for mEC. The median age at diagnosis was 59 years (range 48-71 years), 12 (92%) patients were male, and 9 patients (69%) had adenocarcinoma with the remaining being squamous cell carcinoma. Eleven patients (85%) presented with metastatic disease, while 2 patients (15%) were diagnosed with metastatic disease after having undergone initial surgical resection with disease free intervals of 39 and 14 months respectively. The most common sites of metastases were lymph nodes (11 patients), liver (6 patients), lung (4 patients), bone (3 patients), and peritoneum (2 patients); 77% of patients had at least 2 sites of metastases. The median number of chemotherapy cycles administered was 7 (range 1-14). Four patients (31%) developed grade 3/4 toxicities including neutropenia in 3 patients, nausea in 1 patient, and anemia in 1 patient. One patient (8%) had a complete response (CR), 7 patients (54%) had a partial response (PR), 2 patients (15%) had stable disease (SD), and 3 patients (23%) developed progressive disease (PD). The median progression free survival (PFS) was 5 months (range 0-29 months) and the median overall survival (OS) was 10 months (range 3-36 months). Conclusion: CIP is an active and well tolerated regimen in patients with mEC that merits prospective evaluation. Citation Format: Thomas A. Giever, Paul S. Ritch, James P. Thomas, Lauren A. Wiebe, George B. Haasler, Mario G. Gasparri, David Johnstone, Candice A. Johnstone, Elizabeth M. Gore, Ben George. A combination of cisplatin, irinotecan, and paclitaxel (CIP) as frontline treatment of patients with metastatic esophageal cancer (mEC). [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association f