Jubashi Amane, Kotani Daisuke, Kojima Takashi, Takebe Naoko, Shitara Kohei
Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Curr Probl Cancer. 2024 Dec;53:101152. doi: 10.1016/j.currproblcancer.2024.101152. Epub 2024 Oct 24.
Esophageal cancer is the seventh most common malignancy worldwide and is primarily categorized into adenocarcinoma and squamous cell carcinoma (SCC), with the predominant histological type varying by region. In Western countries, including the United States, adenocarcinoma is more prevalent, whereas in East Asian countries, SCC is more common, with it constituting 86% of cases in Japan. Although there has been an increasing trend of adenocarcinoma in Western populations, SCC still accounts for the majority of esophageal cancer cases globally. Cytotoxic chemotherapy has been the mainstay of treatment, however, targeted therapies including EGFR, FGFR, PI3K, or CDK4/6, despite showing preliminary efficacy signals, have not yet received regulatory approval. Recently, immune checkpoint inhibitors (ICIs) have shown therapeutic efficacy and have been approved as a monotherapy or combination therapy for advanced esophageal SCC (ESCC). Although PD-L1 expression is the only clinically applicable biomarker for first-line therapy with ICIs in ESCC, responses to ICIs are various, and novel predictive biomarkers are under investigation. Furthermore, novel antibody-drug conjugates (ADC) hold promise for advanced ESCC. This review includes the current landscape and future perspectives of potential targeted therapy for advanced ESCC.
食管癌是全球第七大常见恶性肿瘤，主要分为腺癌和鳞状细胞癌（SCC），其主要组织学类型因地区而异。在包括美国在内的西方国家，腺癌更为普遍，而在东亚国家，SCC更为常见，在日本占病例的86%。尽管西方人群中腺癌呈上升趋势，但SCC在全球食管癌病例中仍占大多数。细胞毒性化疗一直是主要治疗方法，然而，包括表皮生长因子受体（EGFR）、成纤维细胞生长因子受体（FGFR）、磷脂酰肌醇-3激酶（PI3K）或细胞周期蛋白依赖性激酶4/6（CDK4/6）在内的靶向治疗，尽管显示出初步疗效信号，但尚未获得监管批准。最近，免疫检查点抑制剂（ICIs）已显示出治疗效果，并已被批准作为晚期食管鳞状细胞癌（ESCC）的单药治疗或联合治疗。尽管程序性死亡受体配体1（PD-L1）表达是ESCC中ICIs一线治疗唯一可临床应用的生物标志物，但对ICIs的反应各不相同，新型预测生物标志物正在研究中。此外，新型抗体药物偶联物（ADC）对晚期ESCC具有前景。本综述包括晚期ESCC潜在靶向治疗的现状和未来展望。
