Immunotherapy For Esophageal Cancer — Has It Worked?

“Esophageal cancer is a very difficult diagnosis.  In the United States there are about 17,000 esophageal cancers a year.  Of those there’s only about 1,000 that get surgery, because the majority of them are identified at such a late stage,” says Dr. Raja Flores, Chairman of Thoracic Surgery at Mt. Sinai School of Medicine.

For the patients whose esophageal cancer is too advanced to be treated with surgery, and who have exhausted other options, this study may be important. The study dealt with 121 patients who had already received two types of chemotherapy combinations, and whose cancer persisted. Patients in the study were enrolled at 57 different sites in ten different countries, which means that there was probably some diversity in lifestyle factors among the patients. Their median age was 65.

Doctors administered the immunotherapy drug through an IV every three weeks for up to two years. Out of the group enrolled, 9.9 percent responded to the immunotherapy drug. Twelve patients had a partial response. Some of the patients who responded to the drug did not have any tumor growth for over a year after treatment, which, according to the study author, is an unheard of success for those patients.

Researchers will probably use the study to petition the Food and Drug Administration to approve the drug for those patients with tumors that develop in the lower part of the esophagus that connects to the stomach, who have not responded to the first two lines of treatment. The drug could also help with other cancers like melanoma, lung and cervical cancer.

The two biggest causes of esophageal cancer are smoking and reflux, also known as heartburn. Heartburn is becoming an increasing problem in the United Staes because it is caused by obesity, according to Dr. Flores. The more that a patient weighs, the more the fat in the belly pushes on the stomach, and the more it pushes the fluid contents of the stomach up into the esophagus. That continuous irritation of the esophagus can cause cancer to develop.

The first line of drug treatment for esophageal cancer is conventional chemotherapy. Usually, this is largely to relieve pain, and doesn’t have long term benefits. Only 15 percent of these patients have a second line of treatment, and fewer receive further treatment after that. The overall survival for metastatic esophageal cancer ranges from about 10 to 12 months.

 

 

 

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