Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A trial comparing 2 combinations of chemotherapy with radiotherapy for oesophageal cancer (Neo SCOPE)
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This trial looked at 2 different combinations of chemotherapy alongside radiotherapy for cancer of the food pipe (oesophagus). It was for people whose cancer:
- could be removed with surgery
- hadn’t spread elsewhere in the body
Cancer Research UK supported this trial
More about this trial
When this trial was done, recent research suggested that chemoradiotherapy before surgery might be better at shrinking the tumour and preventing cancer spread than chemotherapy. The research also suggested some newer chemotherapy drugs might improve treatment. These included:
- oxaliplatin and capecitabine
- paclitaxel and carboplatin
In this trial, researchers looked at these 2 different types of chemotherapy alongside radiotherapy. They hoped to find out which chemoradiotherapy treatment could be looked at in a larger trial. In this larger trial, they planned to compare chemoradiotherapy with chemotherapy. But they needed to do this smaller trial first to find out how well chemoradiotherapy worked and which combination of chemotherapy to use alongside radiotherapy.
The aims of the trial were to:
- find out how well these 2 different types of chemotherapy with radiotherapy worked
- find out how safe treatment was
- learn more about side effects
- find out which chemoradiotherapy treatment could be looked at in a larger trial
Summary of results
The trial team found both chemotherapy combinations were safe to give with radiotherapy and the side effects were similar. But they say carboplatin and paclitaxel worked a bit better.
85 people took part in this trial. To begin with, everyone had 2 cycles of oxaliplatin and capecitabine chemotherapy. Then they were put into 1 of the following 2 treatments groups at random.
- 42 had oxaliplatin and capecitabine alongside radiotherapy
- 43 had carboplatin and paclitaxel alongside radiotherapy
Everyone had some tests to see how much the tumour had shrunk. Those suitable for surgery had their operation 6 to 8 weeks after chemoradiotherapy finished.
The researchers looked at the number of people who had surgery. This was
- 36 people who had oxaliplatin and capecitabine
- 41 people who had carboplatin and paclitaxel
The researchers looked at the tumour removed during surgery. They found the cancer had gone away completely in:
- 4 out of 36 people (11.1%) who had oxaliplatin and capecitabine
- 12 out of 41 people (29.3%) who had carboplatin and paclitaxel
The trial team are also looking at how long people lived for after treatment. This is called overall survival. They are following up people who took part in the trial. They hope to have this information available in autumn 2018.
The serious side effects were similar between the 2 groups. Although people who had carboplatin and paclitaxel had more problems with a drop in the number of white blood cells (
The trial team concluded that carboplatin and paclitaxel alongside radiotherapy worked well enough to be looked at in a future trial. The trial team also say it is safe to have radiotherapy before surgery for oesophageal cancer that has spread into surrounding tissues.
We have a summary of an open trial comparing carboplatin and paclitaxel with another combination of chemotherapy, alongside radiotherapy on our clinical trials database. It is called SCOPE 2.
How to join a clinical trial
Dr Tom Crosby
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
Velindre NHS Trust