Researchers at Wilmot Cancer Institute are working to improve treatment for esophageal cancer, a disease that affects 17,000 Americans each year. Often diagnosed after the cancer has spread, the disease has a low five-year survival rate.
“Even for patients with early stage cancer, the cure rate there is still 50 percent, probably because our treatment is still not precise enough,” says Mohamedtaki Tejani, M.D. “There’s a growing national recognition that these patients need additional systemic therapy, whether that comes out in the form of full doses of additional chemotherapy or immunotherapy.”
Standard treatment for esophageal cancer currently includes combined chemotherapy and radiation followed by surgery. If initial treatment is not successful, patients at Wilmot often receive genomic testing to help determine the next course of action. The testing may reveal a mutation that makes the patient eligible for a clinical trial or for therapy approved for that mutation.
The FDA recently approved pembrolizumab, an immunotherapy drug, for metastatic esophageal cancer in the third-line setting, meaning two other types of treatment have failed. At Wilmot, Tejani is part of a multi-center clinical trial evaluating whether a similar immunotherapy drug called avelumab works better than chemotherapy in treating metastatic esophageal cancer from the beginning.
He is also leading a clinical trial testing the role of additional chemotherapy prior to surgery in reducing the risk of relapse later. Timing is important, Tejani says, and there is some evidence that more chemotherapy after surgery helps. However, recovery from surgery can take months, which makes it difficult for patients to receive additional chemotherapy after their tumor has been removed. Giving additional chemotherapy before surgery may also help shrink the tumor before it has an opportunity to leave the primary site (the esophagus).
There are currently five clinical trials specific to esophageal cancer available at Wilmot. Learn more about them and other clinical trials on our Clinical Trials page.