In a randomized controlled trial, published in the Journal of Cancer Research and Therapeutics, researchers compared paclitaxel and carboplatin and cisplatin and 5FU-based chemoradiation therapy (CRT) regimens in patients with inoperable esophageal cancer. The researchers, led by Divyesh Kumar, reported that paclitaxel and carboplatin was numerically superior to cisplatin and 5FU.
The study included two randomized groups which received either paclitaxel and carboplatin or cisplatin and 5FU alongside two phases of external beam radiation therapy (EBRT). Outcomes were evaluated according to RECIST v1.1 and CTCAE v4.0 criteria.
Paclitaxel and Carboplatin Versus Cisplatin and 5FU
According to the researchers, the overall response rate (ORR) in the paclitaxel/carboplatin group was higher than that in the cisplatin/5FU group, though the difference was not statistically significant (P=.851). Notably, the paclitaxel/carboplatin group exhibited more hematological toxicities, anemia, and reduced cell counts compared to the cisplatin/5FU group. Non-hematological toxicities were comparable.
Likewise, the authors observed that the paclitaxel/carboplatin group had better survival with late toxicities compared to the cisplatin/5FU group, although the difference was not statistically significant either.
Overall, the authors concluded that “paclitaxel/carboplatin CRT shows better response, survival, and comparable toxicities when compared to cisplatin/5FU,” though they acknowledged that larger prospective trials are needed.