Strategies to Improve Treatment - Stage I Esophageal Cancer

This content has been reviewed and approved by

Chandra P. Belani, MD
Deputy Director, Penn State Cancer Institute
Miriam Beckner Professor of Medicine
Penn State University School of Medicine

Researchers are currently investigating new treatments for stage I esophageal cancer. Participation in trials of these treatments will lead to improved therapies. If you wish to participate in a clinical trial, please talk to your doctor about the potential benefits and side effects of the treatment.

• Supportive care - Supportive care refers to treatments designed to prevent and control the side effects of cancer and its treatment. Side effects not only cause patients discomfort but also may prevent the optimal delivery of therapy at its planned dose and schedule. To achieve optimal outcomes from treatment and improve quality of life, it is important to manage appropriately the side effects resulting from cancer and its treatment.
• New combination regimens - Several newer chemotherapeutic drugs demonstrate an ability to kill, or incapacitate, esophageal cancer cells in patients with advanced cancer. Research is ongoing to develop and explore single or multiagent chemotherapy regimens in combination with radiation.
• Adjuvant treatment ( treatment after surgery) - Studies show that treatment with radiation therapy, chemotherapy, or a combination following surgery does not affect survival of patients with stage I esophageal cancer. Developing new multidrug chemotherapy treatment regimens that incorporate new or additional anticancer therapies alone or in combination with radiation therapy is an active area of clinical research.

Newly developed regimens only treat patients with stage I esophageal cancer when those regimens prove superior to current chemotherapy regimens in patients with more advanced cancer. Currently, there is ongoing research into the use of chemotherapy agents paclitaxel and Taxotere^® (docetaxel) in patients with stage I cancer; these drugs are among the most active in treating squamous cell esophageal cancer.

• Neoadjuvant therapy (treatment before surgery) - Receiving chemotherapy and/or radiation therapy before surgery can decrease the size of tumors, making it easier to remove with surgery. However, there is currently no evidence that administering radiation therapy and/or chemotherapy to patients treated with surgery for stage I esophageal cancer is of any benefit.

• Gene therapy - Gene therapy involves transferring new genetic material into a cell for therapeutic benefit. Researchers perform this transfer by replacing or inactivating a faulty (dysfunctional) gene or replacing or adding a working (functional) gene into a cell to restore normal function. Gene therapy attempts to control the rapid growth of cancer cells, control cancer cell death, and help the immune system to kill cancer cells.
  
  

  Currently, there are no approved gene therapies for treating esophageal cancer. A few gene therapy studies are ongoing in patients with esophageal cancer resistant to treatment. Patients with earlier stages of esophageal cancer maybe treated with these therapies, if the studies are successful.