Emerging immunotherapy for the treatment of esophageal cancer

ABSTRACT

Introduction: Esophageal cancer is the third most common cancer of the gastrointestinal tract. Despite new therapies, the prognosis for patients with these cancers remains poor with 5-year survival rates lower than 15%. Recently, immunotherapy has increasingly gained attention as a novel treatment strategy for advanced esophageal cancer.

Areas covered: Recent success of immunotherapy in treating other solid tumors has shed light on the utility of these approaches for esophageal cancers. Here, the authors focus on antibody-based, adoptive-cell-therapy-based, and vaccine-based immunotherapies, and briefly address their rationale, clinical data, and implications.

Expert opinion: Immunotherapy is now established to be a key treatment modality that can improve the outcomes of many cancer patients and appears to be ushering in a new era in cancer treatment. Checkpoint inhibitor drugs have shown preliminary favorable results in esophageal cancer treatment. Adoptive cell therapy and vaccine studies have also shown some promise in various clinical studies. Future endeavors will need to focus on identifying patients who are likely to benefit from immunotherapy, monitoring and managing immune responses and designing optimal combination strategies where immunotherapy agents are combined with other traditional treatment modalities.

KEYWORDS:

• Immunotherapy
• esophageal cancer
• antibody
• adoptive cell therapy
• cancer vaccine

Article highlights

• Immunotherapy is a type of treatment that exploits the immune response of the host (e.g. T-cell or antibody response) to reduce tumor burden or increase patient survival.

• Three widely explored immunotherapeutic strategies are antibody-based immunotherapy, ACT, and vaccine-based immunotherapy.

• Immunotherapy, especially immune checkpoint blockade, has led to considerable clinical benefits in various cancers, including melanoma and lung cancer, and promising initial anticancer efficacy in patients with esophageal cancer.

• Ongoing and future investigations will identify and develop favorable immune profiles or biomarkers predictive of outcomes in patients receiving immunotherapy so that the clinical utility of immunotherapy may be maximized.

• Combination of immunotherapy with other conventional treatment modalities is being actively explored, and further investigations will be necessary to carefully determine the dose/intensity, duration, and timing of combined treatment modalities to maximize the therapeutic benefits of immunotherapy.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.