What's New in Esophageal Cancer Research and Treatment?

Research on the treatment and prevention of esophageal cancer is now being done at many medical centers, university hospitals, and other institutions across the nation.

Genetics: Researchers have found many of the changes in certain genes that appear to be responsible for causing normal cells of the esophagus to develop into esophageal cancer. They expect that additional progress will lead to new tests for finding esophageal cancer at an earlier, more curable stage. Understanding these changes will eventually lead to new gene therapies that repair the abnormal DNA changes in esophageal cancer cells.

Drug treatment: Several clinical trials are in progress to test new ways to combine drugs already known to be active against esophageal cancer to improve their effectiveness are also being done. Other studies are testing the best ways to combine chemotherapy with radiation therapy.

New drugs that target certain substances in the cancer cell are becoming available. This targeted therapy has been successful in other tumors and is now being tested in esophageal cancer. Likewise, drugs that block new blood vessel formation (antiangiogenesis agents) are also becoming available. They have had some success in treating other cancers and will be tested in esophageal cancer.

Immunotherapy: Experimental treatments that boost the patient's immune reaction to fight esophageal cancer more effectively are being tested in clinical trials.

One approach to immunotherapy involves the use of monoclonal antibodies, which are made in the laboratory and then injected into patients to seek out esophageal cancer cells that contain excess amounts of proteins like carcinoembryonic antigen (CEA) or the HER-2 oncogene. Clinical trials currently in progress are testing these antibodies against esophageal adenocarcinoma-type cancer.

Screening and prevention: As the rate of adenocarcinoma rises, efforts are being made to reduce obesity, a major risk factor for this form of cancer (and several types as well). In people with Barrett esophagus, researchers are investigating tests to determine which patients will go on to develop cancer. They are also studying new ways to destroy Barrett mucosa and promote its replacement by normal mucosa.

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