Induction Chemotherapy for Locally Advanced Esophageal Cancer

Prior treatment

• Prior chemotherapy, thoracic radiotherapy or prior surgical resection for an esophageal tumor.

Other illness

• Known non-malignant systemic disease (cardiovascular, renal, hepatic, etc.) that would preclude any of the study therapy drugs.
• Known psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude them from meeting the study requirements.

Age

• Patients with prior malignancies are eligible if they have been disease-free for \> 5 years and are deemed by their physician to be at low risk for recurrence. Patients with squamous or basal cell carcinoma of the skin, melanoma in situ, carcinoma in situ of the cervix, or carcinoma in situ of the colon or rectum that have been effectively treated are eligible, even if these conditions were diagnosed within 5 years prior to randomization.

Other

• Known distant metastases.
• Known ≥ grade 2 neuropathy.
• Women who are pregnant or nursing.
• Women and men of reproductive potential who are expecting to conceive or father children.

• Must have histologically proven adenocarcinoma, squamous cell carcinoma or undifferentiated carcinoma of the esophagus, GE junction and/or gastric cardia.
• Must have potentially resectable disease.
• Must have ECOG performance status 0 or 1.
• Must have adequate organ function as defined by the following criteria:
  • ANC ≥ 1,500/mm3
  • Platelet count ≥ 100,000/mm3
  • Creatinine (Cr) ≤ 1.5 mg and/or creatinine clearance ≥ 60cc/min.
  • Total bilirubin must be ≤ 1.5 x ULN unless the patient has a chronic grade 1 bilirubin elevation due to Gilbert's disease or similar syndrome due to slow conjugation of bilirubin.
  • Alkaline phosphatase must be ≤ 2 x ULN.
  • AST \& ALT must be ≤ 3 x ULN.
• Men and women of reproductive potential must agree to use an effective contraception method
• Must be willing and able to provide written informed consent
• Must be ≥ 18 years or older