Immunotherapy for Esophageal Cancer: State-of-the Art in 2021.
Hugo Teixeira FarinhaAntonia DigkliaDimitrios SchizasNicolas DemartinesMarkus SchäferStyliani MantziariPublished in: Cancers (2022)
The management of esophageal cancer (EC) has experienced manifold changes during the last decades. Centralization of EC treatment has been introduced in many countries, subsequently allowing the development of specialized high-volume centers. Minimal invasive surgery has replaced open surgery in many centers, whereas more potent systemic treatments have been introduced in clinical practice. Newer chemotherapy regimens increase long-term survival. Nevertheless, the overall survival of EC patients remains dismal for advanced tumor stages. In this direction, a wide range of targeted biologic agents (immunotherapy) is currently under assessment. Anti- Human Epidermal Growth Factor Receptor-2 (HER-2) monoclonal antibodies are used in HER2 (+) tumors, predominantly well-differentiated adenocarcinomas, and are currently assessed in the neoadjuvant setting (TRAP, INNOVATION trials). Immune checkpoint inhibitors Nivolumab (ATTRACTION-03) and pembrolizumab (KEYNOTE-181), have demonstrated a survival benefit compared with conventional chemotherapy in heavily pre-treated progressive disease. More recently, CheckMate-577 showed very promising results for nivolumab in a curative adjuvant setting, improving disease-free survival mainly for esophageal squamous cell carcinoma. Several ongoing trials are investigating novel targeted agents in the preoperative setting of locally advanced EC. In addition, other immunomodulatory approaches such as peptide vaccines and tumor infiltrating lymphocytes (TILs) are currently under development and should be increasingly integrated into clinical practice.
Keyphrases
- locally advanced
- free survival
- rectal cancer
- clinical practice
- epidermal growth factor receptor
- minimally invasive
- neoadjuvant chemotherapy
- squamous cell carcinoma
- coronary artery bypass
- advanced non small cell lung cancer
- phase ii study
- radiation therapy
- newly diagnosed
- end stage renal disease
- prognostic factors
- tyrosine kinase
- cancer therapy
- ejection fraction
- endothelial cells
- rheumatoid arthritis
- chronic kidney disease
- multiple sclerosis
- early stage
- patients undergoing
- clinical trial
- palliative care
- induced pluripotent stem cells
- drug induced
- open label
- patient reported