Despite the advances in therapy of cancer, patients with localized (stage II or III) esophageal carcinoma when treated with preoperative chemoradiation have a dismal prognosis (<20% 5-year survival rate). Treatment is associated with dire consequences. Currently, none of the clinical or therapeutic parameters can help to individualize therapy (select certain treatments or avoid others). It is known that response to chemoradiation (as judged by examining the resected specimen) varies. Pathologic complete response (pathCR), defined as the absence of residual cancer, or lack of response (=50% residual cancer or exCRTR) dictates patient outcome. Approximately 25% of patients achieve a pathCR and another 25% exhibit exCRTR. Patients with pathCR survive much longer than those with The goal of this study (R21/R33) is to study untreated cancer tissue from esophageal cancer patients receiving preoperative chemoradiation to discover if certain molecular biomarker classifiers can help individualize therapy. This is being proposed in two phases: retrospective (R21) and prospective (R33). Only promising findings in the R21 will be validated in the R33 phase. In the R21 phase, the immunohistochemistry (IHC) of NFkB, Shh and Gli-1 as well as relevant drug-related biomarkers will be used to establish a distribution and clinical relevance (pathCR and exCRTR) of biomarker signatures. The IHC methods will be standardized and transferred from the research laboratory to a certified IHC clinical laboratory.Public Health Relevance
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