New First-Line Systemic Treatment Options for Metastatic Esophageal Squamous Cell Carcinoma

Presented by:
Michael K. Gibson
Search for other papers by Michael K. Gibson in
Current site
Google Scholar
PubMed
Close
 MD, PhD
Restricted access

Esophageal squamous cell carcinoma is an aggressive malignancy with histologic variability depending on where in the world it is diagnosed, with most of these cancers occurring in China and other parts of Asia. Previous studies with cytotoxic chemotherapy combinations led to a plateau median overall survival of approximately 10 to 12 months, as well as a need for more effective treatment options. Cytotoxic chemotherapy served as the control arm in 3 studies that evaluated the safety and efficacy of immunotherapy + chemotherapy versus chemotherapy alone; in all 3 prospective randomized trials, the addition of immunotherapy resulted in a survival benefit in the first-line relapsed/metastatic setting. Data support these immunotherapy regimens as new standard-of-care systemic therapy options for unresectable, locally advanced, recurrent or metastatic esophageal cancers, and these regimens have now been incorporated into the NCCN Guidelines.

Disclosures: Dr. Gibson has disclosed serving as a scientific advisor for AbbVie, Inc.; receiving consulting fees from Coherus and Daiichi-Sankyo Co.; and receiving grant/research support from Bristol-Myers Squibb Company, Merck & Co., Inc., and Papivax.

Correspondence: Michael K. Gibson, MD, PhD, Vanderbilt-Ingram Cancer Center, 2220 Pierce Avenue, Nashville, TN 37232. Email: mike.gibson.1@vumc.org
  • Collapse
  • Expand
  • 1.

    Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209249.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Arnold M, Soejomataram I, Ferlay J, Forman D. Global incidence of oesophageal cancer by histological subtype in 2012. Gut 2015;64:381387.

  • 3.

    Saltzman JR, Gibson MK. WECC: worldwide esophageal cancer collaboration. Excerpted from UpToDate Card: Dec 19, 2022. Accessed March 31, 2023. Available at: https://bit.ly/ESO1222

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Wang J, Chang J, Yu H, et al. A phase II study of oxaliplatin in combination with leucovorin and fluorouracil as first-line chemotherapy in patients with metastatic squamous cell carcinoma of esophagus. Cancer Chemother Pharmacol 2013;71:905911.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Ajani JA, D’Amico TA, Bentrem DJ, et al. NCCN Clinical Practice Guidelines in Oncology: Esophageal and Esophagogastric Junction Cancers. Version 2.2023. Accessed March 30, 2023. To view the most recent version, visit https://www.nccn.org

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Sun JM, Shen L, Shah MA, et al. Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): a randomised, placebo-controlled, phase 3 study. Lancet 2021;398:759771.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Metges JP, Kato K, Sun JM, et al. First-line pembrolizumab plus chemotherapy versus chemotherapy in advanced esophageal cancer: longer-term efficacy, safety, and quality-of-life results from the phase 3 KEYNOTE-590 study. Presented at the 2022 ASCO Gastrointestinal Cancers Symposium; January 20–22, 2022; San Francisco, CA. Abstract 241.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Doki Y, Ajani JA, Kato K, et al. Nivolumab combination therapy in advanced esophageal squamous cell carcinoma. N Engl J Med 2022;386:449462.

  • 9.

    Kato K, Ajani JA, Doki Y, et al. Nivolumab plus chemotherapy or ipilimumab vs chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma: 29-month follow-up from CheckMate 648. Presented at the 2023 ASCO Gastrointestinal Cancers Symposium; January 19–21, 2023; San Francisco, CA. Abstract 290.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Luo H, Lu J, Bai Y, et al. Effect of camrelizumab vs placebo added to chemotherapy on survival and progression-free survival in patients with advanced or metastatic esophageal squamous cell carcinoma: the ESCORT-1st randomized clinical trial. JAMA 2021;326:916925.

    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 806 554 14
PDF Downloads 430 170 12
EPUB Downloads 0 0 0