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Biological Markers Found That Correlate To Esophageal Cancer Treatment Success

horacic Oncology Program.

While physicians have traditionally used only surgery to treat the cancer, clinical trials are under way using chemotherapy and radiation therapy before surgery. However, the trials have demonstrated no benefit to esophageal cancer patients from this so-called "tri-modality" therapy.

The Duke researchers, however, suspect that the patient group studied was too undifferentiated. By studying patients= tumors on a molecular level, they are seeking to identify a subset of patients who are more likely to benefit from the aggressive tri-modality therapy.

Most tumor cells have different genes and proteins activated compared to normal cells. In some cases tumors express genes that normal cells don=t, and in others the tumors lack genes normally expressed. A third option is for a gene to be altered, or mutated, in a way that scientists can detect. All of these changes are reflected in the presence, lack, or mutation of the genes= product proteins.

By examining the pattern of these genetic alterations, Harpole said he hopes to provide a more detailed picture of tumors to eventually predict patients= responses to treatment. The ultimate goal is to tailor therapy and improve survival.

"We want to know if we can predict from the initial biopsy sample which patients will respond to therapy and survive," he said.

In their study of 112 patients, the research team analyzed tumor samples for genes and their protein products that studies of other cancers, such as colon cancer, indicated had roles in either resistance or sensitivity to chemotherapy or radiation.

After biopsy, the patients underwent chemotherapy and radiation therapy, followed by surgery to remove any remaining tumor tissue. The 34 patients who responded completely to the chemotherapy and radiation and had no viable tumor left at surgery had an average survival longer than five years.

In analyzing the relationship between markers and patients= response
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Contact: Joanna Downer
downe010@mc.duke.edu
919-684-4148
Duke University Medical Center
15-May-1999


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