{'fraction_non_alphanumeric': 0.012890094979647219, 'fraction_numerical': 0.0013568521031207597, 'mean_word_length': 5.3852813852813854, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Is there a future for EGFR targeted agents in esophageal cancer?

In the current issue of the Annals, authors report the results of the SAKK phase III trial, adding the antiEGFR agent cetuximab to preoperative chemoradiotherapy in esophageal squamous cell and adenocarcinoma 1 . The authors observe an improvement in local tumor control for use of cetuximab with reduced local tumor recurrence, which translated into non-significant differences in progression free and overall survival. The trial is relatively small and underpowered and pools together patients with squamous cell and adenocarcinoma. The reduction in local tumor recurrence occurred despite no difference in the achievement of either an R0 resection or a pathologic complete response at surgery. Despite these negative observations, the improved local control with cetuximab is somehow attributed to an enhancement of a radiotherapy effect. The authors do not comment on the pathologic T and N stages achieved with or without the addition of cetuximab. Fewer patients on the control arm had transthoracic resection, which potentially could have increased the risk of local tumor recurrence. There also was less toxicity observed on the arm receiving cetuximab, arguing that these patients potentially had a better baseline functional status. Although the treatment arms appear balanced in pre-treatment characteristics, these two factors could have influenced the ultimate survival outcome in a small trial.