Immunotherapy for esophageal cancer

Some people with esophageal cancer will have immunotherapy. Immunotherapy helps to strengthen or restore the immune system's ability to fight cancer. Immunotherapy is sometimes called biological therapy.

You may have immunotherapy to

• stop esophageal cancer cells from growing and spreading
• kill cancer cells
• control symptoms of advanced or metastatic esophageal cancer

Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of immunotherapy. You may also receive other treatments.

Pembrolizumab (Keytruda) is an immunotherapy drug used for esophageal cancer. It is used as the first treatment in combination with cisplatin and fluorouracil for:

• locally advanced or metastatic squamous cell carcinoma tumours of the esophagus
• HER-2 negative adenocarcinoma tumours found at the gastroesophageal junction

Pembrolizumab can also be used as a first treatment in combination with cisplatin, fluorouracil and a targeted therapy drug called trastuzumab for HER-2 positive adenocarcinoma tumours found at the gastroesophageal junction that are locally advanced unresectable or metastatic.

Nivolumab (Opdivo) is another immunotherapy drug used with esophageal cancer. It may be given to people who still have cancer remaining after neoadjuvant therapy with chemoradiation and surgery to completely remove the tumour.

Nivolumab may also be combined with either cisplatin and fluorouracil or carboplatin and fluorouracil to treat advanced or metastatic adenocarcinoma tumours, or tumours at the gastroesophageal junction.

Ipilimumab (Yervoy) can be used in combination with nivolumab to treat unresectable or metastatic squamous cell carcinoma tumours of the esophagus.

Side effects can happen with any type of treatment for esophageal cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Side effects of immunotherapy will depend mainly on the type of drug or drug combination, the dose, how it's given and your overall health.

Some common side effects of immunotherapy for esophageal cancer are:

• flu-like symptoms, such as fever and chills
• fatigue
• skin problems, including redness, itching, rash and dryness

• cough, shortness of breath

• headache

• nausea and vomiting

• loss of appetite

• constipation

• diarrhea

• pain in the arms or legs, back or abdomen

Tell your healthcare team if you have these side effects or others you think might be from immunotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about immunotherapy. To make the decisions that are right for you, ask your healthcare team questions about immunotherapy.