Advances and challenges in the treatment of esophageal cancer

Abstract

Esophageal cancer (EC) is one of the most common cancers with high morbidity and mortality rates. EC includes two histological subtypes, namely esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). ESCC primarily occurs in East Asia, whereas EAC occurs in Western countries. The currently available treatment strategies for EC include surgery, chemotherapy, radiation therapy, molecular targeted therapy, and combinations thereof. However, the prognosis remains poor, and the overall five-year survival rate is very low. Therefore, achieving the goal of effective treatment remains challenging. In this review, we discuss the latest developments in chemotherapy and molecular targeted therapy for EC, and comprehensively analyze the application prospects and existing problems of immunotherapy. Collectively, this review aims to provide a better understanding of the currently available drugs through in-depth analysis, promote the development of new therapeutic agents, and eventually improve the treatment outcomes of patients with EC.

Comparative genomic analysis of esophageal squamous cell carcinoma and adenocarcinoma: New opportunities towards molecularly targeted therapy

“…However, the options for the treatment of esophageal cancer are limited at present. Endoscopic or surgical treatment is applied to early-stage patients, while radiotherapy or/and chemotherapy is predominant for patients with advanced or metastatic cancer 5 . Therefore, it is urgent to develop new therapies targeting the essential factors involving in the initiation and progression of esophageal carcinoma.…”

Targeted Photodynamic Diagnosis and Therapy for Esophageal Cancer: Potential Role of Functionalized Nanomedicine

“…These drugs are usually given in combinations to improve their efficacies. Furthermore, to limit off-target, increase optimal therapeutic effects, and improve survival outcomes, chemotherapeutic agents are now administrated with some molecular target drugs such as trastuzumab, nivolumab, pembrolizumab, ramucirumab, fam-trastuzumab deruxtecan-nxki, and cetuximab [12,14,15]. Early-stage cancer treated with chemotherapy has shown improved survival rates, particularly in combination with radiation, while a poor prognosis is observed in advanced-stage esophageal cancer [15,16].…”

“…Furthermore, to limit off-target, increase optimal therapeutic effects, and improve survival outcomes, chemotherapeutic agents are now administrated with some molecular target drugs such as trastuzumab, nivolumab, pembrolizumab, ramucirumab, fam-trastuzumab deruxtecan-nxki, and cetuximab [12,14,15]. Early-stage cancer treated with chemotherapy has shown improved survival rates, particularly in combination with radiation, while a poor prognosis is observed in advanced-stage esophageal cancer [15,16]. The continuous usage of the chemotherapeutic agent is characterized by dose-limiting cytotoxicity; drug resistance; and other adverse effects such as neuropathy, neutropenia, pneumonitis, bradycardia myelosuppression, thereby limiting the extensive use of these agents [13].…”

A recombinant scFv antibody-based fusion protein that targets EGFR associated with IMPDH2 downregulation and its drug conjugate show therapeutic efficacy against esophageal cancer

“…Esophageal cancer (EC) is one of the most common cancer worldwide with a high mortality and a relatively low overall 5-year survival rate. EC is divided into two pathological subtypes, namely esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) (Pennathur et al., 2013 ; Fatehi Hassanabad et al., 2020 ; He et al., 2021 ). In the Chinese population, ESCC is the main EC subtype and has a high incidence (Pennathur et al., 2013 ; Lu et al., 2021 ).…”