Study Finds Key Advancement in Care For Esophageal Cancer

A new study led by doctors at Dallas’ Baylor University Medical Center found a major advancement in the fight against esophageal cancer.

An immunotherapy drug has shown in trials to keep cancer from coming back in patients who had esophageal cancer -- the second-highest cause of cancer-related death worldwide.

Cancers that start in the esophagus are much more common in men than in women. Many of these cancers are linked to tobacco or alcohol use, or to excess body weight.

The study found that an immunotherapy drug doubled disease-free survival times for those with operable tumors and lowered the risk of cancer recurrence or death by 31% during the course of the trial.

"This is a big step forward for our patients. Now we have a whole new modality of treatment. Chemo, radiation and surgery, and now the fourth pillar will be immunotherapy for those patients," Baylor Scott & White Dallas-Fort Worth Chief of Oncology Dr. Ronan Kelly said.

Despite years of research, the study marked the first time an immunotherapy drug has been shown to improve disease-free survival among patients with early-stage esophageal or gastroesophageal junction cancers.

The standard of care for esophageal cancer includes chemotherapy, radiation and surgery, however, it doesn't often lead to complete removal of cancer.

"We only see about 20-25% having a great response, so the vast majority, 75%, are not in that category and we haven't had another option to offer these patients," said Kelly, who is also the chair of immunology at Baylor University Medical Center in Dallas.

The results of this study have led the therapy to become a potential new standard of care for esophageal and gastroesophageal cancers, which are notoriously difficult to treat and have seen limited advances over the last few decades.

Jay Fisher of Dallas joined the trial after undergoing chemo, radiation and surgery for esophageal cancer, which came with no warning, as often is the case with this kind of cancer.

"I was actually on vacation, on a cruise, when I started having difficulty swallowing," Fisher said.

He is not sure whether he received the placebo or the immunotherapy drug but said his scans show he has remained cancer-free since his surgery in 2019.

"I consider myself a very positive person and I told myself I am going to beat this," Fisher said. "So with help of doctors and prayers, I think that's how I got through."

Early esophageal cancer typically causes no signs or symptoms.

According to cancer.org, although many people with esophageal cancer will go on to die from this disease, treatment has improved and survival rates are improving. During the 1960s and 70s, only about 5% of patients survived at least five years after being diagnosed. Now, about 20% of patients survive at least five years after diagnosis.

The chance of getting esophageal cancer increases with age. Fewer than 15% of cases are found in people younger than 55 years old.

Men are more likely than women to get esophageal cancer.

Tobacco products, including cigarettes, cigars, pipes, and chewing tobacco, are a major risk factor for esophageal cancer. The more a person uses tobacco and the longer it is used, the higher the cancer risk.