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Current neoadjuvant therapy for operable locally advanced esophageal cancer

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Abstract

Locally advanced esophageal cancer has a poor prognosis, while an increasing number of patients are diagnosed with that. Neoadjuvant therapy has become a hot topic in treating locally advanced esophageal cancer to improve its survival benefit. The efficacy of neoadjuvant therapy followed by surgery has been confirmed by many studies, and neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy are included in the guidelines. In recent years, targeted therapy and immunotherapy have emerged, and more studies are evaluating the efficacy of combining them with neoadjuvant therapy for operable esophageal cancer patients. Even though the preliminary data is disappointing, many trials are still under investigation without improving survival benefits. New indexes used as surrogate endpoints (e.g., major pathologic response and pathological complete response) are emerging to accelerate the development and approval of neoadjuvant drugs. This review summarized the research progress in neoadjuvant therapy for locally advanced esophageal cancer and discussed which primary endpoint should be used in neoadjuvant therapy trials.

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Abbreviations

EC:

Esophageal Cancer

ESCC:

Esophageal Squamous Cell Carcinoma

EAC:

Esophageal Adenocarcinoma

NRT:

Neoadjuvant Radiotherapy

NCCN:

National Comprehensive Cancer Network

NCT:

Neoadjuvant Chemotherapy

RCT:

Randomized Clinical Trial

5-FU:

5-fluorouracil

CF:

Cisplatin plus 5-FU

VS:

Versus

HR:

Hazard Ratio

GEJ:

Gastroesophageal Junction

PFS:

Progression Free Survival

OS:

Overall Survival

DFS:

Disease Free Survival

NCRT:

Neoadjuvant Chemoradiotherapy

pCR:

pathological Complete Response

mOS:

median Overall Survival

ECX:

Epirubicin, Cisplatin plus Capecitabine

ECF:

Epirubicin, Cisplatin plus 5-FU

EGFR:

Epidermal Growth Factor Receptor

VEGFR:

Vascular Endothelial Growth Factor Receptor

HER2:

Human Epidermal Growth Factor Receptor-2

ASCO:

American Society of Clinical Oncology

FLOT:

Docetaxel, Oxaliplatin, Calcium folinate plus 5-FU

CAPOX:

Capecitabine plus Oxaliplatin

PD-1:

Programmed Death 1

PD-L1:

Programmed Death Ligand 1

DCF:

Docetaxel, Cisplatin plus 5-FU

MPR:

Major Pathologic Response

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Funding

This work was supported by the National Natural Science Foundation of China (Grant No.82072756).

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Authors and Affiliations

  1. National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

    Wenwei Yang, Yaru Niu & Yongkun Sun

  2. National Cancer Center, National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang, 065001, China

    Yongkun Sun

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  1. Wenwei Yang
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YW contributed to the composition of the manuscript and literature review. NY contributed to the literature review. SY contributed to the supervision and supported final approval of the article. All authors contributed to the manuscript revision and read and approved the final version.

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Correspondence to Yongkun Sun.

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Yang, W., Niu, Y. & Sun, Y. Current neoadjuvant therapy for operable locally advanced esophageal cancer. Med Oncol 40, 252 (2023). https://doi.org/10.1007/s12032-023-02097-4

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