Strategies to Improve Treatment - Stage II 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 II 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 - There are several newer chemotherapeutic drugs that demonstrate an ability to kill esophageal cancer cells in patients with advanced cancer. Research is ongoing to develop and explore single or multiagent chemotherapy regimens including the taxanes, Gemzar^® (gemcitabine), and other newer chemotherapy drugs with or without radiation in patients with stage II cancer.
• New adjuvant regimens - There is no research to show that treating patients with radiation therapy, chemotherapy, or both therapies after surgery affects the survival of patients with stage II 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 investigation.
• New neoadjuvant regimens (treatment before surgery) - Developing new multidrug chemotherapy treatment regimens that incorporate new or additional anticancer therapies is an active area of clinical research. Neoadjuvant therapy may consist of chemotherapy alone or in combination with radiation therapy or biologic agents (substances made from living organisms). The potential effectiveness of neoadjuvant chemotherapy and radiation therapy is an active area of investigation in clinical trials, which are primarily evaluating newer combination chemotherapy regimens.
• Neoadjuvant and adjuvant treatment - Although initial clinical trials do not show this approach to be superior to surgery alone, researchers continue to evaluate neoadjuvant low-dose chemotherapy before surgery followed by additional adjuvant chemotherapy after surgery.
• 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.