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Esophageal carcinoma: Towards targeted therapies

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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.

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  1. Ali Fatehi Hassanabad and Rania Chehade contributed equally to this work.

Authors and Affiliations

  1. Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Ali Fatehi Hassanabad

  2. Department of Medicine, Schulich School of Medicine and Dentistry, Schulich School of Medicine and Dentistry at Western University, London, ON, Canada

    Rania Chehade

  3. Department of Oncology, Division of Medical Oncology, London Regional Cancer Program, Schulich School of Medicine and Dentistry at Western University, London, ON, Canada

    Daniel Breadner & Jacques Raphael

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Fatehi Hassanabad, A., Chehade, R., Breadner, D. et al. Esophageal carcinoma: Towards targeted therapies. Cell Oncol. 43, 195–209 (2020). https://doi.org/10.1007/s13402-019-00488-2

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