Advances in targeted therapy for esophageal cancer

Abstract

Esophageal cancer (EC) is one of the most lethal cancers in the world, and its morbidity and mortality rates rank among the top ten in China. Currently, surgical resection, radiotherapy and chemotherapy are the primary clinical treatments for esophageal cancer. However, outcomes are still unsatisfactory due to the limited efficacy and severe adverse effects of conventional treatments. As a new type of approach, targeted therapies have been confirmed to play an important role in the treatment of esophageal cancer; these include cetuximab and bevacizumab, which target epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF), respectively. In addition, other drugs targeting surface antigens and signaling pathways or acting on immune checkpoints have been continuously developed. For example, trastuzumab, a monoclonal antibody targeting human epidermal growth factor receptor 2 (HER-2), has been approved by the Food and Drug Administration (FDA) as a first-line treatment of HER-2-positive cancer. Moreover, the PD-L1 inhibitor pembrolizumab has been approved as a highly efficient drug for patients with PD-L1-positive or advanced esophageal squamous cell carcinoma (ESCC). These novel drugs can be used alone or in combination with other treatment strategies to further improve the treatment efficacy and prognosis of cancer patients. Nevertheless, adverse events, optimal dosages and effective combinations still need further investigation. In this review, we expound an outline of the latest advances in targeted therapies of esophageal cancer and the mechanisms of relevant drugs, discuss their efficacy and safety, and provide a clinical rationale for precision medicine in esophageal cancer.

Systematic profiling of ferroptosis gene signatures predicts prognostic factors in esophageal squamous cell carcinoma

“…The 5-year overall survival (OS) of advanced ESCC is only 18.8%. 3 , 4 Unfortunately, most patients have advanced-stage diseases at first diagnosis, generally because of the absence of clinical symptoms. 5 Recently, multidisciplinary therapy methods, including surgical resection, radiotherapy, chemotherapy, and targeted therapy, provide new options to prolong OS.…”

Advances in Drug Resistance of Esophageal Cancer: From the Perspective of Tumor Microenvironment

“…EC can be histologically classified as esophageal squamous cell carcinoma (ESCC) or esophageal adenocarcinoma (EAC), which has distinct pathogenesis, molecular characteristics, and geographical distribution ( Cancer Genome et al, 2017 ; Lagergren et al, 2017 ). Clinically, chemotherapy has been one of the major therapeutic approaches in the trimodality therapy of EC; molecular targeted therapy and immune checkpoint inhibitors have been evaluating in preclinical and clinical trials ( van Hagen et al, 2012 ; Smyth et al, 2017 , 2021 ; Yang et al, 2020 ). However, despite recent advances in multidisciplinary management, the treatment of EC is still a relentless challenge partly owing to the fact that numerous patients are intrinsically insensitive or adaptively resistant to therapeutic agents.…”

Mining genes related to microenvironment of esophageal squamous cell carcinoma based on TCGA database

“…Nowdays, it has been reported that a variety of biomarkers can affect the prognosis of patients with esophageal cancer by changing the immune microenvironment of the tumor, such as MiR-201, MiR-503 and PD-L1 [19][20][21] . PD-L1 has been proved to be the target of immunotherapy for patients with ESCC [22] . In this study, we analyzed the survival correlation of 223 DEGs.…”