Esophageal cancer 2015: Targeted therapy becomes an option

December 30, 2014 | by Tami Dennis

Jae Kim, M.D. City of Hope's Jae Kim offers his perspective on expected esophageal cancer advances for 2015.

Think “precision.” Doctors can now prescribe specific drugs that focus specifically on cancer cells, avoiding the healthy cells that need to be preserved. This kind of therapy, known as targeted therapy, has been increasingly available for lung cancer and some other diseases; now it can be used for esophageal cancer as well.

“Esophageal cancer has lagged behind other cancers in terms of having targeted drugs, rather than conventional chemotherapy, to fight the cancer,” said Jae Kim, M.D., chief of the Division of Thoracic Surgery at City of Hope. That’s now changing, with Herceptin, better known as a breast cancer drug, now a promising option.

“Trastuzumab (Herceptin) was approved in 2010 for treatment of patients with metastatic esophageal cancer whose tumors overexpress HER2,” Kim said. “City of Hope is currently participating in a multicenter trial using a combination of trastuzumab, chemotherapy, radiation and surgery for earlier stage patients with esophageal adenocarcinoma.”

That’s not all. “There is also hope that another targeted therapy, gefitinib (Iressa), may hold promise for some esophageal cancer patients,” Kim said. “Disappointing results from a randomized trial of gefitinib vs. placebo for second-line treatment of metastatic esophageal cancer published this year failed to show a survival benefit for gefitinib. However, a biomarker analysis found that the drug actually benefited a select group of patients that had amplification of the EGFR gene.”

Such seemingly mixed results are part of the research process. The key for scientists and physicians is to figure out which patients the drugs will help, and which patients would better benefit from other therapies.

As for those latest Iressa results, Kim said: “This is in keeping with other studies of targeted therapies, which show that the drugs only benefit patients with specific biomarkers. The drug is not currently approved for use in esophageal cancer, but these results are promising and we may have more data about this in 2015.”

More data, too, is part of the research process. That’s how advances are made.

Sayeh Hirmand contributed to this report.

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Learn more about esophageal cancer treatment and esophageal cancer research  at City of Hope.

Learn more about becoming a patient or getting a second opinion at City of Hope by visiting our website or by calling 800-826-HOPE (4673). City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.

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