Executive Summary
Several research studies have been conducted to seek more information on esophageal cancer, related prevention methods, diagnostic process at the initial phase, and best treatments strategies. Research on esophageal cancer implicates the ongoing clinical trials and appropriate doctor communication with the patients and their families, providing effective treatment. Researchers are looking at using aspirin and acid-reducing medication to prevent oesophagal adenocarcinoma in people with Barrett’s oesophagus for chemoprevention. Researchers are studying PET scans to evaluate and possibly change the treatment before surgery. Research is going to find new drugs that are effective for esophageal cancer. Several targeted therapies are currently being studied for esophageal cancer. Researchers look at new drugs that block vascular endothelial growth factors (VEGF). Clinical trials are going on to find more acceptable ways of lessening symptoms and side effects of current cancer treatments to improve comfort and quality of life during treatment.
Advancement in Esophageal Cancer Research
Doctors are learning more about esophageal cancer, ways to prevent it, the best way to treat it, and how to give the best care to people diagnosed with this disease. The following research areas may comprise new alternatives for patients with the help of clinical trials. Always talk with the doctor about the best diagnostic and treatment options for you.
Genetics
Researchers have found 4 inherited syndromes that raise the risk of esophageal cancer. They have found specific genes related to 3 of these syndromes, and more research is being done. Researchers hope to find additional genes and to come up with more detailed recommendations for screening to find esophageal cancer early in people at high risk because of these syndromes.
Tests
Liquid biopsy
Researchers are studying liquid biopsies for cancer screening, diagnosis, and treatment. Most liquid biopsies are done using a sample of blood, but samples of urine, spinal fluid, or pleural effusions (fluid around the lungs) can also be used. It is much easier to get a sample of blood for testing than to get a sample of the tumor with a needle, and studies have shown that liquid biopsies do contain tumor cells as well as pieces of DNA from the tumor.
Current research is testing esophageal cancer DNA from liquid biopsies to find specific mutations. Researchers are hoping to find out if the gene changes could help doctors choose the best drugs for patients. Studies are also looking at whether the liquid biopsy tumor DNA can help predict how the tumor might respond to certain drugs, or how likely it might be to come back after treatment.
Imaging tests
Currently, people with esophageal cancer who get chemo or chemoradiation before surgery (neoadjuvant treatment) will have another imaging test after treatment to find out whether the tumor has gotten small enough to do surgery. Researchers are studying if a PET scan can help doctors decide the next step in treatment. For example, should people who were treated with neoadjuvant chemotherapy whose PET scans still show signs of cancer be treated with radiation therapy or a different chemotherapy to try and shrink the cancer more before getting surgery?
- Chemoprevention – Researchers are looking at using aspirin and acid-reducing medication to prevent esophageal adenocarcinoma in people with Barrett’s esophagus 1. Research is still ongoing, and people are encouraged to talk with their doctor before taking any medications or dietary supplements for this reason.
- Use of PET scan – In addition to helping find out cancer’s stage, PET scans may be used to determine how well treatment is working to shrink a tumor before surgery. Researchers are studying PET scans to evaluate and possibly change the treatment before surgery 2.
- Chemotherapy advances – Doctors are studying combinations of different drugs, such as cisplatin (available as a generic drug), capecitabine (Xeloda), docetaxel (Docefrez, Taxotere), Efudex), irinotecan (Camptosar), fluorouracil (5-FU, oxaliplatin (Eloxatin), paclitaxel, and trifluridine-tipiracil combination (Lonsurf). Research is going to find new drugs that are effective for esophageal cancer 3.
- Targeted therapy – Several targeted therapies are currently being studied for esophageal cancer. For example, researchers look at new drugs that block vascular endothelial growth factors (VEGF) 4.
- Immunotherapy – New drugs and combinations that include immunotherapy continue to be studied 5.
- Palliative care/supportive care – Clinical trials are going on to find more acceptable ways of lessening symptoms and side effects of current cancer treatments to improve comfort and quality of life during treatment.
References
- 1.Le Bras GF, Farooq MH, Falk GW, Andl CD. Esophageal cancer: The latest on chemoprevention and state of the art therapies. Pharmacological Research. Published online November 2016:236-244. doi:10.1016/j.phrs.2016.08.021
- 2.Seol KH, Lee JE. PET/CT planning during chemoradiotherapy for esophageal cancer. Radiat Oncol J. Published online 2014:31. doi:10.3857/roj.2014.32.1.31
- 3.He S, Xu J, Liu X, Zhen Y. Advances and challenges in the treatment of esophageal cancer. Acta Pharmaceutica Sinica B. Published online November 2021:3379-3392. doi:10.1016/j.apsb.2021.03.008
- 4.Yang YM, Hong P, Xu WW, He QY, Li B. Advances in targeted therapy for esophageal cancer. Sig Transduct Target Ther. Published online October 7, 2020. doi:10.1038/s41392-020-00323-3
- 5.Puhr HC, Preusser M, Ilhan-Mutlu A. Immunotherapy for Esophageal Cancers: What Is Practice Changing in 2021? Cancers. Published online September 15, 2021:4632. doi:10.3390/cancers13184632