New image-guided agent helps target tumors in esophageal cancer patients

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A new anti-tumor agent, when delivered endoscopically and used in combination with chemotherapy and radiation therapy, can lead to improved survival rates in patients with locally advanced esophageal cancer, according to a study released at the 73rd annual scientific meeting of the American College of Gastroenterology in Orlando, Fla.

Lead investigator Kenneth Chang of University of California Irvine Medical Center, MD, and his colleagues conducted a phase 2 multi-center study on the safety and long-term efficacy of a new biologic therapy (TNFerade), an injection of an anti-tumor agent, in 24 patients with locally advanced esophageal cancer.

Patients received standard care chemotherapy and radiation. In addition, the patients received TNFerade through a standard endoscope or endoscopic ultrasound that guided the injection directly into the esophageal tumor. TNFerade contains a non-replicating virus, which has been engineered to deliver the gene for a cancer fighting protein, TNF-alpha and works synergistically with chemoradiation representing a "triple threat" to cancer cells.

TNFerade was administered once a week for a total of 5 treatments. Surgery was performed 5-11 weeks after completion of therapy. Researchers monitored the effects of this combined therapy by observing the side effects, tumor response and overall survival.

Researchers found most tumors were adenocarcinoma and locally advanced, but still potential candidates for surgery.

TNFerade, in combination with chemoradiation in this group of patients, resulted in a median survival of 48.4 months, in contrast to previously published trials showing a median survival of 9.7 to 34 months. At one particular dose, all four of the patients were alive without any recurrence at 48 months. Three of these patients had tumor resections, which showed no residual cancer cells in the surgical specimens.

The results showed that TNFerade is “a promising treatment that represents a new paradigm in esophageal cancer treatment, with the gastroenterologist administering the local anti-tumor agent through a scope,” according to Chang.