Immunotherapy as a new perspective for the therapy of esophageal cancer

TL;DR

Immunotherapy is becoming a key treatment for esophageal cancer, with new approvals for checkpoint inhibitors in various stages and cancer types.

Contribution

The paper highlights recent approvals and combinations of immune checkpoint inhibitors for treating esophageal cancer.

Findings

Adjuvant immunotherapy with nivolumab is approved for SCC and GEJ cancer after successful preoperative treatment.

Nivolumab combined with chemotherapy or ipilimumab is effective for first-line metastatic SCC with TPS ≥1%.

Pembrolizumab and trastuzumab are approved for specific subgroups of gastric and GEJ cancer patients.

Abstract

The therapeutic landscape in nearly every therapeutic line in advanced/metastatic patients with squamous cell carcinoma (SCC) and esophagogastric adenocarcinoma (EGC) is enriched by recent approvals of immune checkpoint inhibitors (ICIs). In curative intended therapy, patients without pathological residual disease of SCC or GEJ (esophagogastric junction) cancer after preoperative chemoradiation and complete resection have access to adjuvant immunotherapy (independent of PD-L1 (programmed cell death protein 1) status, nivolumab, CHECKMATE 577). For metastatic SCC in the first-line, nivolumab combined with chemotherapy or with ipilimumab (TPS (tumor proportion score) ≥1 %, SCC, CHECKMATE 648) are approved, as well as second-line nivolumab alone regardless of PD-L1 status (ATTRACTION 03). For both, locally advanced or metastatic SCC and EGC, chemotherapy with pembrolizumab is available for patients with CPS (combined positive score) ≥10 (KEYNOTE 590) and for adenocarcinoma with nivolumab (CPS ≥5, CHECKMATE 649). Recent added approvals are chemotherapy with pembrolizumab in CPS ≥1 patients (KEYNOTE 859) and the addition of trastuzumab for personalized therapy in HER-2 positive/CPS ≥1 gastric and GEJ patients (KEYNOTE 811).

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