title: Basis for molecular diagnostics and immunotherapy for esophageal cancer.
abstract: Esophageal cancer (EC) is an extremely aggressive neoplasm, diagnosed in about 17,000 Americans every year with a mortality rate of more than 80% within five years and a median overall survival of just 13 months. For decades, the go-to regimen for esophageal cancer patients has been the use of taxane and platinum-based chemotherapy regimens, which has yielded the field's most dire survival statistics. Areas covered: Combination immunotherapy and a more robust molecular diagnostic platform for esophageal tumors could improve patient management strategies and potentially extend lives beyond the current survival figures. Analyzing a panel of biomarkers including those affiliated with taxane and platinum resistance (ERCC1 and TUBB3) as well as immunotherapy effectiveness (PD-L1) would provide oncologists more information on how to optimize first-line therapy for EC. Expert commentary: Of the 12 FDA-approved therapies in EC, zero target the genome. A majority of the approved drugs either target or are effected by proteomic expression. Therefore, a broader understanding of diagnostic biomarkers could give more clarity and direction in treating esophageal cancer in concert with a greater use of immunotherapy.
authors.affiliation: a Department of Clinical and Translational Science , Creighton University School of Medicine , Omaha , NE , USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Abdo
authors.affiliation: a Department of Clinical and Translational Science , Creighton University School of Medicine , Omaha , NE , USA.
authors.forename: Devendra K
authors.initials: DK
authors.lastname: Agrawal
authors.affiliation: a Department of Clinical and Translational Science , Creighton University School of Medicine , Omaha , NE , USA.|b Department of Surgery , Creighton University School of Medicine (Phoenix campus), Norton Thoracic Institute, Dignity Health , Phoenix , AZ , USA.
authors.forename: Sumeet K
authors.initials: SK
authors.lastname: Mittal
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D025202:Molecular Diagnostic Techniques; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor
keywords: CTLA-4 inhibitors; Esophageal cancer; PD-L1 inhibitors; combination immunotherapy; esophageal adenocarcinoma; molecular oncology; precision medicine; proteomics; targeted chemotherapy; targeted therapy