{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:04:30Z","timestamp":1787954670891,"version":"build-2784847793"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2024,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    No study has unequivocally proven that chemotherapy prolongs overall survival (OS) in advanced esophageal cancer. We conducted a Phase III randomized study in first\u2010line advanced unresectable\/metastatic esophageal\/GEJ cancer. Patients aged 18\u201370\u2009years, with performance status 0\u20132, were randomized to best supportive care (BSC) alone, or BSC with weekly paclitaxel 80\u2009mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    . BSC comprised, as indicated, education, counselling, radiation, stenting, feeding tube placement, nutritional supplementation, medications like analgesics, and referral to a support group and palliative care. The primary endpoint was OS; secondary endpoints included progression free survival (PFS), response, toxicity, and QoL. Between May 2016\u2013December 2020, we recruited 281 patients: 143 to chemotherapy and 138 to BSC. Histopathology was squamous in 269 (95.7%) patients. Median number of paclitaxel doses was 12 (IQR, 7\u201323). Median OS was 4.2\u2009months (95% CI, 3.42\u20135.32) in BSC, and 9.2\u2009months (95% CI, 8.02\u201310.48) in chemotherapy; HR, 0.49 (95% CI, 0.39\u20130.64);\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001. As compared to BSC, chemotherapy increased response (2.9% to 39%), median PFS (2.1 to 4.2\u2009months), 1\u2010year OS (11% to 32%), 2\u2010year OS (0 to 9%), median dysphagia\u2010free survival (2.9 to 14.8\u2009months), and global and esophagus\u2010specific QoL, without significantly increasing all\u2010grade or grade \u22653 toxicities. Using ESMO clinical benefit scale and ASCO Value Framework, palliative chemotherapy scored as having \u201csubstantial value.\u201d Our study provides the first level 1 evidence that chemotherapy prolongs survival in advanced esophageal\/GEJ carcinoma. BSC alone is no longer appropriate. Weekly paclitaxel is an attractive option, especially in LMICs with limited access to immunotherapy.\n                  <\/jats:p>","DOI":"10.1002\/ijc.35111","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T13:15:24Z","timestamp":1722604524000},"page":"2232-2245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Phase\n                    <scp>III<\/scp>\n                    randomized trial comparing palliative systemic therapy to best supportive care in advanced esophageal\/\n                    <scp>GEJ<\/scp>\n                    cancer"],"prefix":"10.1002","volume":"155","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0191-2744","authenticated-orcid":false,"given":"Vanita","family":"Noronha","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Hospital, Homi Bhabha National Institute  Mumbai 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Homi Bhabha National Institute  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minit","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Hospital, Homi Bhabha National Institute  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sucheta","family":"More","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Hospital, Homi Bhabha National Institute  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srushti","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Hospital, Homi Bhabha National Institute  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akanksha","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Hospital, Homi Bhabha National Institute  Mumbai 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