New Strides in Esophageal Cancer Management

By Daniela Molena, MD and Yelena Y. Janjigian, MD,

Friday, September 23, 2016

At Memorial Sloan Kettering Cancer Center (MSK), we have made significant strides in the management of esophageal cancer over the past ten years. Improvements in postoperative care and the introduction of minimally invasive techniques have decreased the number of postoperative complications, resulting in better long-term recovery and quality of life for more patients. We have introduced robotic and laparoscopic approaches and are actively studying what benefits these new techniques might bring compared with more traditional methods.

Advances in Early Disease Management

We have made significant improvements in the management of very early cancers. For many patients with early-stage disease, surgery is no longer necessary: Tumors can be successfully removed endoscopically, with close postoperative follow-up. Our gastroenterologists have extensive experience working with these advanced techniques. For patients with more advanced cancers, MSK has also been at the forefront, developing multimodality approaches, including administering chemotherapy and radiation before surgery. This strategy has become the standard of care in most centers around the world, based on a recently published clinical trial. (1), (2)

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Novel Clinical Trials for Esophageal Cancer

We are also actively involved in participating in and leading national clinical trials for new approaches to treating this difficult cancer. For example, we are currently recruiting for a pilot study to assess the effectiveness of a drug called 89Zr-DFO-trastuzumab to determine whether it enhances the appearance of esophagogastric cancer on PET scan. The results of this study may enable doctors to use PET scanning to identify certain types of esophagogastric tumors, eliminating the need for a biopsy. We are also exploring the use of novel targeted therapies to improve the chances of cure following treatment and are leading a trial to seek a biomarker of esophageal cancer, which could help guide treatment decisions for future patients.

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The MSK Difference

The Esophageal Disease Management Team at MSK includes surgeons, medical oncologists, radiation oncologists, gastroenterologists, and dedicated nursing and support staff. Leveraging our multidisciplinary approach, we create an individualized treatment plan for all patients tailored to their specific disease.

MSK is one of the highest-volume esophageal surgery centers in North America. Our experience and expertise allow us to achieve surgical morbidity and mortality rates among the best in the nation.

Learn more about the esophageal cancer program at MSK by visiting https://www.mskcc.org/cancer-care/types/esophageal/treatment.

For more information and to inquire about eligibility for our Pilot Trial of PET Imaging with 89Zr-DFO-Trastuzumab in Esophagogastric Cancer, please contact Dr. Yelena Janjigian at 646-888-4186.

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  1. Allum WH, Stenning SP, Bancewicz J, Clark PI, Langley RE. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol 2009;27(30):5062-7.

  2. Ilson DH, Minsky BD, Ku GY, et al. Phase 2 trial of induction and concurrent chemoradiotherapy with weekly irinotecan and cisplatin followed by surgery for esophageal cancer. Cancer 2012;118(11):2820-7.