Challenges and perspectives for immunotherapy in oesophageal cancer: A look to the future (Review)

Abstract

Oesophageal cancer is one of the most aggressive malignancies with limited treatment options, thus resulting in a high morbidity and mortality. With 5-year survival rates of only 5-10%, oesophageal cancer holds a dismal prognosis for patients. In order to improve overall survival, the early diagnosis and tools for patient stratification for personalized treatment are urgent needs. A minority of oesophageal cancers belong to the spectrum of Lynch syndrome-associated cancers and are characterized by microsatellite instability (MSI). Microsatellite instability is a consequence of defective mismatch repair protein functions and it has been well characterized in other gastrointestinal tumours, such as colorectal and gastric cancer. In the latter, high levels of MSI are associated with a better prognosis and with an increased benefit to immune-based therapies. Therefore, similar therapeutic approaches could offer an opportunity of treatment for oesophageal cancer patients with MSI. Apart from immune checkpoint inhibitors, other immunotherapies such as adoptive T-cell transfer, peptide vaccine and oncolytic viruses are under investigation in oesophageal cancer patients. In the present review, the rationale and current knowledge about immunotherapies in oesophageal cancer are summarised.

Real-world experience with anti–programmed cell death protein 1 immunotherapy in patients with esophageal cancer: A retrospective single-center study

“…In other words, a suitable biomarker can help us further screen out potential benefit groups for immunotherapy for EPC. Among the common immunotherapy biomarkers, the expression of PD-L1 has been most extensively studied (15). In a meta-analysis involving 4,174 patients with advanced tumors (including lung cancer, kidney cancer, head and neck cancer, melanoma, and urothelial cancer), the patients received nivolumab, pembrolizumab, or atezolizumab treatment, respectively, and the analysis results showed that both PD-L1-positive and PD-L1-negative patients can benefit from PD-1 or PD-L1 blocking therapy, in which the survival benefit of pembrolizumab treatment for PD-L1-negative patients was minimal.…”

Advances in immunotherapy for metastatic esophageal cancer

“…Biomarker research is underway, to select the potential patients most likely to benefit from therapy and spare others from side effects (e.g., inflammation of skin, intestines, endocrine system, and liver) and failure of treatment. [3]…”