Targeted Therapies and Immunotherapies in the Treatment of Esophageal Cancers
Esophageal cancer (EC) is among the most frequent and deadly cancers around the world. While esophageal adenocarcinoma (EAC) has one of the fastest-growing incidences amongst cancers in the US, it also has one of the lowest survival rates due to the limited effective treatment options. Fortunately,...
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MDPI AG
2019-09-01
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| Series: | Medical Sciences |
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| Online Access: | https://www.mdpi.com/2076-3271/7/10/100 |
| _version_ | 1828328690528813056 |
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| author | Adam Barsouk Prashanth Rawla Andreas V. Hadjinicolaou John Sukumar Aluru Alexander Barsouk |
| author_facet | Adam Barsouk Prashanth Rawla Andreas V. Hadjinicolaou John Sukumar Aluru Alexander Barsouk |
| author_sort | Adam Barsouk |
| collection | DOAJ |
| description | Esophageal cancer (EC) is among the most frequent and deadly cancers around the world. While esophageal adenocarcinoma (EAC) has one of the fastest-growing incidences amongst cancers in the US, it also has one of the lowest survival rates due to the limited effective treatment options. Fortunately, in the past decade, two targeted therapies and an immunotherapy agent have been approved by the FDA for metastatic EAC and esophageal squamous cell carcinoma (ESCC), with several more currently being considered for approval. In terms of immunotherapies, in July 2019, the FDA approved the PD1 inhibitor pembrolizumab for second-line treatment of PDL1-positive, advanced or metastatic ESCC. Two years before, pembrolizumab had been approved for the third-line treatment of PDL1-positive EAC. The PD1 inhibitor nivolumab, which was found in one study to outperform chemotherapy irrespective of PDL1 status, has yet to secure FDA approval. In terms of targeted therapies, although as many as 90% of EC cases show upregulated EGFR, anti-EGFR therapy has not been shown to improve survival. Ramucirumab, an antibody targeting both VEGF and HER2/neu receptors, has been approved for the treatment of refractory EAC, while the anti-HER2 monoclonal antibody (mAb) trastuzumab has been approved as front-line treatment for HER2-positive cases which account for approximately 20% of ECs. Although these targeted therapies and immunotherapies have resulted in significant improvements in survival for specific patient populations that are positive for certain biomarkers, such as PDL1 and HER2/neu, the survival rates remain low for a large proportion of the metastatic EC patient population, necessitating the development of further targeted treatment options. |
| first_indexed | 2024-04-13T20:13:49Z |
| format | Article |
| id | doaj.art-980fc51eb3da49798b8ac1c1d11de2c9 |
| institution | Directory Open Access Journal |
| issn | 2076-3271 |
| language | English |
| last_indexed | 2024-04-13T20:13:49Z |
| publishDate | 2019-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medical Sciences |
| spelling | doaj.art-980fc51eb3da49798b8ac1c1d11de2c92022-12-22T02:31:46ZengMDPI AGMedical Sciences2076-32712019-09-0171010010.3390/medsci7100100medsci7100100Targeted Therapies and Immunotherapies in the Treatment of Esophageal CancersAdam Barsouk0Prashanth Rawla1Andreas V. Hadjinicolaou2John Sukumar Aluru3Alexander Barsouk4Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA 15232, USADepartment of Medicine, Sovah Health, Martinsville, VA 24112, USAAcademic Clinical Post-Doctoral Fellow and Gastroenterology Resident, MRC Cancer Unit and Department of Gastroenterology, University of Cambridge, Cambridge CB2 0XZ, UKSenior Research Associate, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02212, USAHematologist-Oncologist, Allegheny Health Network, Pittsburgh, PA 15212, USAEsophageal cancer (EC) is among the most frequent and deadly cancers around the world. While esophageal adenocarcinoma (EAC) has one of the fastest-growing incidences amongst cancers in the US, it also has one of the lowest survival rates due to the limited effective treatment options. Fortunately, in the past decade, two targeted therapies and an immunotherapy agent have been approved by the FDA for metastatic EAC and esophageal squamous cell carcinoma (ESCC), with several more currently being considered for approval. In terms of immunotherapies, in July 2019, the FDA approved the PD1 inhibitor pembrolizumab for second-line treatment of PDL1-positive, advanced or metastatic ESCC. Two years before, pembrolizumab had been approved for the third-line treatment of PDL1-positive EAC. The PD1 inhibitor nivolumab, which was found in one study to outperform chemotherapy irrespective of PDL1 status, has yet to secure FDA approval. In terms of targeted therapies, although as many as 90% of EC cases show upregulated EGFR, anti-EGFR therapy has not been shown to improve survival. Ramucirumab, an antibody targeting both VEGF and HER2/neu receptors, has been approved for the treatment of refractory EAC, while the anti-HER2 monoclonal antibody (mAb) trastuzumab has been approved as front-line treatment for HER2-positive cases which account for approximately 20% of ECs. Although these targeted therapies and immunotherapies have resulted in significant improvements in survival for specific patient populations that are positive for certain biomarkers, such as PDL1 and HER2/neu, the survival rates remain low for a large proportion of the metastatic EC patient population, necessitating the development of further targeted treatment options.https://www.mdpi.com/2076-3271/7/10/100esophageal cancermetastatictargeted therapyimmunotherapynovel therapeutics |
| spellingShingle | Adam Barsouk Prashanth Rawla Andreas V. Hadjinicolaou John Sukumar Aluru Alexander Barsouk Targeted Therapies and Immunotherapies in the Treatment of Esophageal Cancers Medical Sciences esophageal cancer metastatic targeted therapy immunotherapy novel therapeutics |
| title | Targeted Therapies and Immunotherapies in the Treatment of Esophageal Cancers |
| title_full | Targeted Therapies and Immunotherapies in the Treatment of Esophageal Cancers |
| title_fullStr | Targeted Therapies and Immunotherapies in the Treatment of Esophageal Cancers |
| title_full_unstemmed | Targeted Therapies and Immunotherapies in the Treatment of Esophageal Cancers |
| title_short | Targeted Therapies and Immunotherapies in the Treatment of Esophageal Cancers |
| title_sort | targeted therapies and immunotherapies in the treatment of esophageal cancers |
| topic | esophageal cancer metastatic targeted therapy immunotherapy novel therapeutics |
| url | https://www.mdpi.com/2076-3271/7/10/100 |
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