Trial supports patient choice for oesophageal cancer treatment

A trial has found all treatment options for advanced cancer of the oesophagus, sometimes called the gullet or food pipe, have similar outcomes.

It provides support for patients and their doctors to work together to decide on the treatment option most suited to them.

All options equal

The Neo-AEGIS trial compared combinations of treatments for patients with advanced oesophageal cancer. This affects the oesophagus - the tube our food travels down when we swallow to reach our stomach.

A total of 377 patients from five countries took part. There were 199 from sites in the UK, including University Hospital Southampton. They all joined between January 2013 and January 2021.

This trial compared patient outcomes from two different treatment combinations. The first was chemotherapy before and after surgery to remove the cancer. The second was giving chemotherapy and radiotherapy before surgery.

The results showed very little difference in the outcomes of these patients. Survival over the next three years was similar for all patients. There were no major differences in quality-of-life outcomes related to their health or the surgery.

The results are published in The Lancet Gastroenterology and Hepatology.

Shared decision-making

The trial authors recommend considering various factors when choosing treatments. These included patient choice, access to immunotherapy treatments, and the logistics of combining chemotherapy, radiotherapy and surgery.

The trial was led by Chief Investigator Professor John Reynolds and Cancer Trials Ireland. The UK arm of the trial was funded by Cancer Research UK.

The Cancer Research UK Southampton Clinical Trials Unit (CTU) supported the trial. They coordinated its opening in the UK, led by Chief Investigator and surgeon Shaun Preston.

Professor Gareth Griffiths, Director of the Southampton CTU, said: “We were delighted to be involved in running the international Neo-Aegis trial here in the UK.

“This was the first randomised controlled clinical trial to compare these treatment regimens for patients with advanced cancer of the junction between the oesophagus and stomach.

“The data shows that patients on both treatment regimens have similar outcomes and supports clinician and patient decision making as to which to use in individual cases.”