Strategies to Improve Treatment - Stage IV 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 IV esophageal cancer. Participation in trials of these treatments can 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 they 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 chemotherapy regimens - Developing new multidrug chemotherapy treatment regimens that incorporate new or additional anticancer therapies is an ongoing area of clinical research in phase 2 clinical trials (testing new treatments on patients to determine proper dosage and assess side effects). Researchers are conducting these studies in patients with stage IV or recurrent esophageal cancer. The most commonly used regimens include: Platinol^® (cisplatin)/Camptosar^® (irinotecan), cisplatin/Taxotere^® (docetaxel) and cisplatin/Taxol_® (paclitaxel) with or without 5-FU.

Phase 1 trials - Researchers continue to work on developing new chemotherapy drugs or other anticancer therapies in phase 1 clinical trials. The purpose of phase 1 trials is to evaluate new therapies to determine the best way of administering the drug and to determine whether the drug has any anticancer activity in patients with esophageal cancer. Patients with stage IV esophageal cancer should consider participating in phase I trials.

Multiple drug resistance inhibitors - Esophageal cancer may be drug-resistant at the outset of treatment. Drug resistance may also develop after treatment. Several drugs are in testing to determine if they have the potential to overcome or prevent multiple drug resistance from developing in esophageal and other cancers.

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.