Response Prädiktion beim neoadjuvant therapierten Adenokarzinom des Ösophagus
Introduction: Mainly patients with advanced esophageal adenocarcinoma who respond to neoadjuvant chemotherapy show a significant survival benefit after resection. Therefore prediction of response before treatment is desirable. The aim of this study was to assess genetic predictors of response and survival for patients with esophageal adenocarcinoma prior to neoadjuvant therapy. Patients and Methods: Thirty-two patients with advanced esophageal adenocarcinoma who underwent neoadjuvant therapy with resection of their tumor were analyzed for TS, ERCC1 and GSTP-1 mRNA levels prior to the treatment. These results were analyzed in regard of response and survival. Results: In total 18 patients responded to the chemotherapy. Seventeen of those did show a gene expression level at or below the respective median of at least one gene. For TS and ERCC1 this had a profound impact on survival demonstrating an increase in survival for patients who have TS or ERCC1 mRNA level at or below the median. For GSTP-1 no difference in survival could be found. Conclusion: These results demonstrate a potential predictive value of a gene expression profile available prior to therapy. These data have to be confirmed by larger prospective trials.