title: Neoadjuvant Treatment for Locally Invasive Esophageal Cancer.
abstract: Locally advanced esophageal carcinoma has a poor prognosis, and epidemiologic trends show that more patients are being diagnosed with locally advanced esophageal carcinoma and with adenocarcinoma histology. This prompts a review and evaluation of the field regarding standard of care treatment for patients with locally advanced esophageal carcinoma, both adenocarcinoma and squamous cell carcinoma. We review the evidence showing the moderate benefit of neoadjuvant chemoradiation followed by esophagectomy compared to perioperative chemotherapy plus esophagectomy in patients who are good operative candidates. Also, we summarize the emerging clinical trial landscape in the perioperative setting primarily seeking to apply targeted therapies against HER2 (trastuzumab or pertuzumab) or immune checkpoint inhibitors against programmed death 1 (PD-1; pembrolizumab and nivolumab) or programmed death ligand 1 (PD-L1; durvalumab). Understanding the foundations that have determined the current standard of care for patients with locally advanced esophageal carcinoma will aid in interpreting the clinical trial results that will soon appear with the novel treatment strategies.
authors.affiliation: Division of Hematology/Oncology, Northwestern Feinberg School of Medicine, Arkes Pavilion, 676 North Saint Clair, Suite 850, Chicago, IL, 60611, USA.
authors.forename: Wade T
authors.initials: WT
authors.lastname: Iams
authors.affiliation: Division of Hematology/Oncology, Northwestern Feinberg School of Medicine, Arkes Pavilion, 676 North Saint Clair, Suite 850, Chicago, IL, 60611, USA. victoria.villaflor@nm.org.
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Villaflor
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000628:therapy; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000628:therapy*; D016629:Esophagectomy; D006801:Humans; D020360:Neoadjuvant Therapy