Follow the light.

Esophageal cancer may be the next to embrace PET imaging as a biomarker for best therapy. The initial results of the Phase 2 CALGB 80803 indicate that PET-adaptive induction chemo achieves a pathological complete response rate in non-responders of 15.6% (versus a historical rate of null). 257 patients with resectable esophageal and GEJ adenos received baseline PET and then were randomized to induction FOLFOX vs carbo/Taxol with repeat PET at 5-6 weeks. Non-responders (≤35% decrease in SUV) crossed over to the alternate chemo concurrent to their pre-op radiation. Of note, though not designed to assess this, the raw numbers favor the FOLFOX induction arm for all-comers. There is still a lot to learn here, but this is certainly a promising PET project.