Recent advances in treating oesophageal cancer

Kazuto Harada, Jane E Rogers, Masaaki Iwatsuki, Kohei Yamashita, Hideo Baba, Jaffer A Ajani, Kazuto Harada, Jane E Rogers, Masaaki Iwatsuki, Kohei Yamashita, Hideo Baba, Jaffer A Ajani

Abstract

Esophageal cancer (EC) is an aggressive malignancy with an increasing incidence and a poor prognosis. EC is histologically divided into two major categories: adenocarcinoma (EAC) and squamous cell carcinoma (ESCC). EAC and ESCC are molecularly different and therefore treatments should reflect the respective histological subtype. Combined modality therapy is needed for localized EC. When EC is advanced (stage 4), systemic therapy is the mainstay treatment for palliation. For localized EC, several strategies are considered standard, and more trials are necessary to determine a unified and more effective approach. The management for advanced EC is slowly evolving as immunotherapy is showing some promise for ESCC, but more data from ongoing studies are anticipated. Treatment advances will be based on high-definition genomic investigation of individual tumors. Herein, we review the contemporary trends in diagnosing and treating EAC and ESCC.

Keywords: esophageal adenocarcinoma; esophageal cancer; esophageal squamous cell carcinoma.

Conflict of interest statement

No competing interests were disclosed.No competing interests were disclosed.No competing interests were disclosed.No competing interests were disclosed.

Copyright: © 2020 Harada K et al.

References

    1. Global Burden of Disease Cancer Collaboration, : Fitzmaurice C Abate D et al. : Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2019;5(12):1749–1768. 10.1001/jamaoncol.2019.2996

    2. Faculty Opinions Recommendation

    1. Lewis SJ, Smith GD: Alcohol, ALDH2, and esophageal cancer: A meta-analysis which illustrates the potentials and limitations of a Mendelian randomization approach. Cancer Epidemiol Biomarkers Prev. 2005;14(8):1967–71. 10.1158/1055-9965.EPI-05-0196
    1. Freedman ND, Abnet CC, Leitzmann MF, et al. : A Prospective Study of Tobacco, Alcohol, and the Risk of Esophageal and Gastric Cancer Subtypes. Am J Epidemiol. 2007;165(12):1424–33. 10.1093/aje/kwm051
    1. Turati F, Tramacere I, La Vecchia C, et al. : A meta-analysis of body mass index and esophageal and gastric cardia adenocarcinoma. Ann Oncol. 2013;24(3):609–17. 10.1093/annonc/mds244

    2. Faculty Opinions Recommendation

    1. Hvid-Jensen F, Pedersen L, Drewes AM, et al. : Incidence of Adenocarcinoma among Patients with Barrett's Esophagus. N Engl J Med. 2011;365(15):1375–83. 10.1056/NEJMoa1103042

    2. Faculty Opinions Recommendation

    1. Cancer Genome Atlas Research Network; Analysis Working Group: Asan University; BC Cancer Agency: Integrated genomic characterization of oesophageal carcinoma. Nature. 2017;541(7636):169–75. 10.1038/nature20805

    2. Faculty Opinions Recommendation

    1. Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, et al. : Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2015;47(9):829–54. 10.1055/s-0034-1392882
    1. Ajani JA, D’Amico TA, Almhanna K, et al. : Esophageal and Esophagogastric Junction Cancers, Version 1.2015. J Natl Compr Canc Netw. 2015;13(2):194–227. 10.6004/jnccn.2015.0028
    1. Abe S, Ishihara R, Takahashi H, et al. : Long-term outcomes of endoscopic resection and metachronous cancer after endoscopic resection for adenocarcinoma of the esophagogastric junction in Japan. Gastrointest Endosc. 2019;89(6):1120–8. 10.1016/j.gie.2018.12.010

    2. Faculty Opinions Recommendation

    1. Ishihara R, Oyama T, Abe S, et al. : Risk of metastasis in adenocarcinoma of the esophagus: A multicenter retrospective study in a Japanese population. J Gastroenterol. 2017;52(7):800–808. 10.1007/s00535-016-1275-0
    1. Terheggen G, Horn EM, Vieth M, et al. : A randomised trial of endoscopic submucosal dissection versus endoscopic mucosal resection for early Barrett's neoplasia. Gut. 2017;66(5):783–93. 10.1136/gutjnl-2015-310126
    1. van Hagen P, Hulshof MCCM, van Lanschot JJB, et al. : Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer. N Engl J Med. 2012;366(22):2074–84. 10.1056/NEJMoa1112088

    2. Faculty Opinions Recommendation

    1. Shapiro J, van Lanschot JJB, Hulshof MCC, et al. : Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): Long-term results of a randomised controlled trial. Lancet Oncol. 2015;16(9):1090–8. 10.1016/S1470-2045(15)00040-6

    2. Faculty Opinions Recommendation

    1. Tepper J, Krasna MJ, Niedzwiecki D, et al. : Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer: CALGB 9781. J Clin Oncol. 2008;26(7):1086–92. 10.1200/JCO.2007.12.9593
    1. Mariette C, Dahan L, Mornex F, et al. : Surgery Alone Versus Chemoradiotherapy Followed by Surgery for Stage I and II Esophageal Cancer: Final Analysis of Randomized Controlled Phase III Trial FFCD 9901. JCO. 2014;32(23):2416–22. 10.1200/JCO.2013.53.6532

    2. Faculty Opinions Recommendation

    1. Cunningham D, Allum WH, Stenning SP, et al. : Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11–20. 10.1056/NEJMoa055531

    2. Faculty Opinions Recommendation

    1. Elimova E, Janjigian YY, Mulcahy M, et al. : It Is Time to Stop Using Epirubicin to Treat Any Patient With Gastroesophageal Adenocarcinoma. JCO. 2017;35(4):475–7. 10.1200/JCO.2016.69.7276
    1. Al-Batran SE, Homann N, Pauligk C, et al. : Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): A randomised, phase 2/3 trial. Lancet. 2019;393(10184):1948–57. 10.1016/S0140-6736(18)32557-1

    2. Faculty Opinions Recommendation

    1. Ychou M, Boige V, Pignon JP, et al. : Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: An FNCLCC and FFCD multicenter phase III trial. J Clin Oncol. 2011;29(13):1715–21. 10.1200/JCO.2010.33.0597

    2. Faculty Opinions Recommendation

    1. Medical Research Council Oesophageal Cancer Working Group: Surgical resection with or without preoperative chemotherapy in oesophageal cancer: A randomised controlled trial. Lancet. 2002;359(9319):1727–33. 10.1016/S0140-6736(02)08651-8
    1. Allum WH, Stenning SP, Bancewicz J, et al. : Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol. 2009;27(30):5062–7. 10.1200/JCO.2009.22.2083
    1. Alderson D, Cunningham D, Nankivell M, et al. : Neoadjuvant cisplatin and fluorouracil versus epirubicin, cisplatin, and capecitabine followed by resection in patients with oesophageal adenocarcinoma (UK MRC OE05): An open-label, randomised phase 3 trial. Lancet Oncol. 2017;18(9):1249–60. 10.1016/S1470-2045(17)30447-3
    1. Cunningham D, Stenning SP, Smyth EC, et al. : Peri-operative chemotherapy with or without bevacizumab in operable oesophagogastric adenocarcinoma (UK Medical Research Council ST03): Primary analysis results of a multicentre, open-label, randomised phase 2-3 trial. Lancet Oncol. 2017;18(3):357–70. 10.1016/S1470-2045(17)30043-8

    2. Faculty Opinions Recommendation

    1. Harada K, Lopez A, Shanbhag N, et al. : Recent advances in the management of gastric adenocarcinoma patients. F1000Res. 2018;7. 10.12688/f1000research.15133.1
    1. Bang YJ, van Cutsem E, Feyereislova A, et al. : Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): A phase 3, open-label, randomised controlled trial. Lancet. 2010;376(9742):687–97. 10.1016/S0140-6736(10)61121-X

    2. Faculty Opinions Recommendation

    1. Wilke H, Muro K, van Cutsem E, et al. : Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): A double-blind, randomised phase 3 trial. Lancet Oncol. 2014;15(11):1224–35. 10.1016/S1470-2045(14)70420-6
    1. Fuchs CS, Tomasek J, Yong CJ, et al. : Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): An international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2014;383(9911):31–9. 10.1016/S0140-6736(13)61719-5
    1. Kang JH, Lee SI, Lim DH, et al. : Salvage chemotherapy for pretreated gastric cancer: A randomized phase III trial comparing chemotherapy plus best supportive care with best supportive care alone. J Clin Oncol. 2012;30(13):1513–8. 10.1200/JCO.2011.39.4585
    1. Le DT, Durham JN, Smith KN, et al. : Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science. 2017;357(6349):409–13. 10.1126/science.aan6733

    2. Faculty Opinions Recommendation

    1. Fuchs CS, Doi T, Jang RW, et al. : Safety and Efficacy of Pembrolizumab Monotherapy in Patients With Previously Treated Advanced Gastric and Gastroesophageal Junction Cancer: Phase 2 Clinical KEYNOTE-059 Trial. JAMA Oncol. 2018;4(5):e180013. 10.1001/jamaoncol.2018.0013

    2. Faculty Opinions Recommendation

    1. Kang YK, Boku N, Satoh T, et al. : Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to or intolerant of at least two previous chemotherapy regimens (ONO-4538-12, ATTRACTION-2): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017;390(10111):2461–71. 10.1016/S0140-6736(17)31827-5

    2. Faculty Opinions Recommendation

    1. Shitara K, Doi T, Dvorkin M, et al. : Trifluridine/tipiracil versus placebo in patients with heavily pretreated metastatic gastric cancer (TAGS): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2018;19(11):1437–48. 10.1016/S1470-2045(18)30739-3

    2. Faculty Opinions Recommendation

    1. Nentwich MF, von Loga K, Reeh M, et al. : Depth of submucosal tumor infiltration and its relevance in lymphatic metastasis formation for T1b squamous cell and adenocarcinomas of the esophagus. J Gastrointest Surg. 2014;18(2):242–9; discussion 249. 10.1007/s11605-013-2367-2
    1. Kitagawa Y, Uno T, Oyama T, et al. : Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society: Part 1. Esophagus. 2019;16(1):1–24. 10.1007/s10388-018-0641-9

    2. Faculty Opinions Recommendation

    1. Kitagawa Y, Uno T, Oyama T, et al. : Esophageal cancer practice guidelines 2017 edited by the Japan esophageal society: Part 2. Esophagus. 2019;16(1):25–43. 10.1007/s10388-018-0642-8

    2. Faculty Opinions Recommendation

    1. Akutsu Y, Uesato M, Shuto K, et al. : The overall prevalence of metastasis in T1 esophageal squamous cell carcinoma: a retrospective analysis of 295 patients. Ann Surg. 2013;257(6):1032–8. 10.1097/SLA.0b013e31827017fc
    1. Yamashina T, Ishihara R, Nagai K, et al. : Long-term outcome and metastatic risk after endoscopic resection of superficial esophageal squamous cell carcinoma. Am J Gastroenterol. 2013;108(4):544–51. 10.1038/ajg.2013.8
    1. Minashi K, Nihei K, Mizusawa J, et al. : Efficacy of Endoscopic Resection and Selective Chemoradiotherapy for Stage I Esophageal Squamous Cell Carcinoma. Gastroenterology. 2019;157(2):382–390.e3. 10.1053/j.gastro.2019.04.017

    2. Faculty Opinions Recommendation

    1. Lordick F, Mariette C, Haustermans K, et al. : Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27(Suppl 6):vi51–6. 10.1093/annonc/mdt342
    1. Bedenne L, Michel P, Bouché O, et al. : Chemoradiation Followed by Surgery Compared With Chemoradiation Alone in Squamous Cancer of the Esophagus: FFCD 9102. JCO. 2007;25(10):1160–8. 10.1200/JCO.2005.04.7118
    1. Ando N, Kato H, Igaki H, et al. : A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19(1):68–74. 10.1245/s10434-011-2049-9
    1. Bleiberg H, Conroy T, Paillot B, et al. : Randomised phase II study of cisplatin and 5-fluorouracil (5-FU) versus cisplatin alone in advanced squamous cell oesophageal cancer. Eur J Cancer. 1997;33(8):1216–20. 10.1016/s0959-8049(97)00088-9
    1. Lorenzen S, Schuster T, Porschen R, et al. : Cetuximab plus cisplatin-5 fluorouracil versus cisplatin-5-fluorouracil alone in first-line metastatic squamous cell carcinoma of the esophagus: A randomized phase II study of the Arbeitsgemeinschaft Internistische Onkologie. Ann Oncol. 2009;20(10):1667–73. 10.1093/annonc/mdp069
    1. Muro K, Hamaguchi T, Ohtsu A, et al. : A phase II study of single-agent docetaxel in patients with metastatic esophageal cancer. Ann Oncol. 2004;15(6):955–9. 10.1093/annonc/mdh231
    1. Kato K, Tahara M, Hironaka S, et al. : A phase II study of paclitaxel by weekly 1-h infusion for advanced or recurrent esophageal cancer in patients who had previously received platinum-based chemotherapy. Cancer Chemother Pharmacol. 2011;67(6):1265–72. 10.1007/s00280-010-1422-x
    1. Burkart C, Bokemeyer C, Klump B, et al. : A phase II trial of weekly irinotecan in cisplatin-refractory esophageal cancer. Anticancer Res. 2007;27(4C):2845–8.
    1. Kojima T, Muro K, Francois E, et al. : Pembrolizumab versus chemotherapy as second-line therapy for advanced esophageal cancer: Phase III KEYNOTE-181 study. JCO. 2019;37(15):2 10.1200/JCO.2019.37.15_suppl.4010
    1. Kato K, Cho BC, Takahashi M, et al. : Nivolumab versus chemotherapy in patients with advanced oesophageal squamous cell carcinoma refractory or intolerant to previous chemotherapy (ATTRACTION-3): A multicentre, randomised, open-label, phase 3 trial. The Lancet Oncology. 2019;20(11):1506–17. 10.1016/S1470-2045(19)30626-6

    2. Faculty Opinions Recommendation

    1. Shah MA, Kojima T, Hochhauser D, et al. : Efficacy and Safety of Pembrolizumab for Heavily Pretreated Patients With Advanced, Metastatic Adenocarcinoma or Squamous Cell Carcinoma of the Esophagus: The Phase 2 KEYNOTE-180 Study. JAMA Oncol. 2019;5(4):546–50. 10.1001/jamaoncol.2018.5441

    2. Faculty Opinions Recommendation

    1. Chan KKW, Saluja R, Delos Santos K, et al. : Neoadjuvant treatments for locally advanced, resectable esophageal cancer: A network meta-analysis. Int J Cancer. 2018;143(2):430–7. 10.1002/ijc.31312

    2. Faculty Opinions Recommendation

    1. Swisher SG, Hofstetter W, Komaki R, et al. : Improved long-term outcome with chemoradiotherapy strategies in esophageal cancer. Ann Thorac Surg. 2010;90(3):892–8; discussion 898–9. 10.1016/j.athoracsur.2010.04.061
    1. Stahl M, Walz MK, Stuschke M, et al. : Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol. 2009;27(6):851–6. 10.1200/JCO.2008.17.0506
    1. Burmeister BH, Thomas JM, Burmeister EA, et al. : Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase II trial. Eur J Cancer. 2011;47(3):354–60. 10.1016/j.ejca.2010.09.009
    1. Klevebro F, Alexandersson von Döbeln G, Wang N, et al. : A randomized clinical trial of neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy for cancer of the oesophagus or gastro-oesophageal junction. Ann Oncol. 2016;27(4):660–7. 10.1093/annonc/mdw010

    2. Faculty Opinions Recommendation

    1. Nakamura K, Kato K, Igaki H, et al. : Three-arm phase III trial comparing cisplatin plus 5-FU (CF) versus docetaxel, cisplatin plus 5-FU (DCF) versus radiotherapy with CF (CF-RT) as preoperative therapy for locally advanced esophageal cancer (JCOG1109, NExT study). Jpn J Clin Oncol. 2013;43(7):752–5. 10.1093/jjco/hyt061
    1. Harada K, Wu CC, Wang X, et al. : Total Lesion Glycolysis Assessment Identifies a Patient Fraction With a High Cure Rate Among Esophageal Adenocarcinoma Patients Treated With Definitive Chemoradiation. Ann Surg. 2020;272:311–8. 10.1097/SLA.0000000000003228
    1. Harada K, Wang X, Shimodaira Y, et al. : Early Metabolic Change after Induction Chemotherapy Predicts Histologic Response and Prognosis in Patients with Esophageal Cancer: Secondary Analysis of a Randomized Trial. Target Oncol. 2018;13(1):99–106. 10.1007/s11523-017-0540-3
    1. Swisher SG, Moughan J, Komaki RU, et al. : Final Results of NRG Oncology RTOG 0246: An Organ-Preserving Selective Resection Strategy in Esophageal Cancer Patients Treated with Definitive Chemoradiation. J Thorac Oncol. 2017;12(2):368–74. 10.1016/j.jtho.2016.10.002
    1. Noordman BJ, Spaander MCW, Valkema R, et al. : Detection of residual disease after neoadjuvant chemoradiotherapy for oesophageal cancer (preSANO): A prospective multicentre, diagnostic cohort study. Lancet Oncol. 2018;19(7):965–74. 10.1016/S1470-2045(18)30201-8

    2. Faculty Opinions Recommendation

    1. Noordman BJ, Wijnhoven BPL, Lagarde SM, et al. : Neoadjuvant chemoradiotherapy plus surgery versus active surveillance for oesophageal cancer: A stepped-wedge cluster randomised trial. BMC Cancer. 2018;18(1):142. 10.1186/s12885-018-4034-1
    1. Kato K, Igaki H, Ito Y, et al. : Parallel-group controlled trial of esophagectomy versus chemoradiotherapy in patients with clinical stage I esophageal carcinoma (JCOG0502). JCO. 2019;37(4_suppl):7 10.1200/JCO.2019.37.4_suppl.7
    1. Mitchell KG, Nelson DB, Corsini EM, et al. : Morbidity following salvage esophagectomy for squamous cell carcinoma: The MD Anderson experience. Dis Esophagus. 2020;33(3):doz067. 10.1093/dote/doz067
    1. Nomura M, Kato K, Ando N, et al. : Comparison between neoadjuvant chemotherapy followed by surgery and definitive chemoradiotherapy for overall survival in patients with clinical Stage II/III esophageal squamous cell carcinoma (JCOG1406-A). Jpn J Clin Oncol. 2017;47(6):480–6. 10.1093/jjco/hyx040
    1. Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513(7517):202–9. 10.1038/nature13480

    2. Faculty Opinions Recommendation

    1. Wang R, Song S, Harada K, et al. : Multiplex profiling of peritoneal metastases from gastric adenocarcinoma identified novel targets and molecular subtypes that predict treatment response. Gut. 2019;69(1):18–31. 10.1136/gutjnl-2018-318070
    1. Reeh M, Effenberger KE, Koenig AM, et al. : Circulating Tumor Cells as a Biomarker for Preoperative Prognostic Staging in Patients With Esophageal Cancer. Ann Surg. 2015;261(6):1124–30. 10.1097/SLA.0000000000001130

    2. Faculty Opinions Recommendation

    1. Alix-Panabières C, Pantel K: Clinical Applications of Circulating Tumor Cells and Circulating Tumor DNA as Liquid Biopsy. Cancer Discov. 2016;6(5):479–91. 10.1158/-15-1483

    2. Faculty Opinions Recommendation

    1. Chaudhuri AA, Binkley MS, Osmundson EC, et al. : Predicting Radiotherapy Responses and Treatment Outcomes Through Analysis of Circulating Tumor DNA. Semin Radiat Oncol. 2015;25(4):305–12. 10.1016/j.semradonc.2015.05.001

    2. Faculty Opinions Recommendation

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