Abstract

Background

Patients with esophageal cancer are confronted with high mortality rates. Whether it is esophageal squamous cell carcinoma (ESCC) or esophageal adenocarcinoma (EAC), patients usually present at advanced stages, with treatment options traditionally involving chemotherapy in metastatic settings. With the comprehensive genomic characterization of esophageal cancers, targeted therapies are gaining interest and agents such as ramucirumab, trastuzumab and pembrolizumab are already being used for the treatment of EAC.

Conclusions

Pembrolizumab has recently been FDA-approved for PD-L1 positive, locally advanced or metastatic ESCC. Despite comprehensive molecular characterization, however, available targed therapies for ESCC are still lagging behind. Herein, we discuss current trends towards more targeted therapies in esophageal cancers, taking into consideration unique features of ESCCs and EACs. Patients progressing on standard therapies should be subjected to genomic profiling and considered for clinical trials aimed at testing targeted therapies. Future targeted therapies may include CDK4/6 inhibitors, PARP inhibitors and inhibitors targeting the NRF2 and Wnt signaling pathways. Ultimately, optimized biomarker assays and next generation sequencing platforms may allow for the identification of subcategories of ESCC and EAC patients that will benefit from selective targeted therapies and/or combinations thereof.

中文翻译：

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食道癌：靶向治疗

摘要

背景

食道癌患者面临高死亡率。无论是食道鳞状细胞癌（ESCC）还是食道腺癌（EAC），患者通常都处于晚期，传统上在转移环境中采用化学疗法进行治疗。随着食管癌基因组的全面表征，靶向治疗越来越引起人们的关注，诸如拉莫西单抗，曲妥珠单抗和派姆单抗的药物已经用于治疗EAC。

结论

派姆单抗最近被FDA批准用于PD-L1阳性，局部晚期或转移性ESCC。尽管具有全面的分子表征，但是，ESCC可用的靶向治疗仍然落后。在此，我们考虑到食管癌和食管癌的独特特征，讨论了食管癌靶向治疗的最新趋势。接受标准疗法治疗的患者应接受基因组分析，并考虑进行旨在测试靶向疗法的临床试验。未来的靶向疗法可能包括CDK4 / 6抑制剂，PARP抑制剂和靶向NRF2和Wnt信号通路的抑制剂。最终，