CCS is actively monitoring and responding to the recommendations of the Public Health Agency of Canada regarding coronavirus disease (COVID-19).
Stay informed and inspired!
Subscribe to our monthly e-newsletter×
Treatment has improved for many different cancer types, but the esophageal cancer survival rate remains low. Fortunately, a recent study has shed new light on this hard-to-treat cancer and could greatly improve treatment options.
What is esophageal cancer?
Esophageal cancer starts in the cells of the esophagus. The esophagus is part of the digestive system. It is a hollow, muscular tube behind the windpipe and in front of the spine. It carries food and drink from the back of the mouth to the stomach.
Esophageal cancers are classified into 2 main types based on how the tumours look under the microscope:
- Esophageal squamous cell carcinoma typically occurs in the upper and middle part of the esophagus and is linked to smoking and drinking alcohol
- Esophageal adenocarcinoma is generally found in the lower part of the esophagus near the stomach and is associated with obesity and several other risk factors
Esophageal cancers can be different from each other
In the new study, published in Nature, researchers looked at the genetic make-up of 164 esophageal tumours. They found that the 2 main types of esophageal cancer are genetically very different and should not be treated the same way.
In fact, esophageal adenocarcinomas more closely resemble one type of stomach cancer, and squamous cell carcinomas more closely resemble mouth and throat cancer. The researchers even found 4 distinct subgroups within esophageal squamous cell carcinoma that could lead to more tailored treatment strategies.
Thus, this research questions the notion that esophageal cancer is a single disease.
Esophageal cancers should be treated differently
The very different biological make-up of these tumours suggests that different treatments are needed.
For instance, more than 30% of esophageal adenocarcinomas have too many copies of the HER2 gene. Some cases of breast cancer are similar and are treated with HER2-targeted therapies, such as Herceptin. Esophageal cancer patients with too much HER2 might also benefit from this type of therapy.
Traditionally, treatment strategies have been decided by where the tumour is growing in the body and how it looks under the microscope. Current research is challenging this standard practice by highlighting that cancers developing in the same part of the body can vary greatly in their genetic make-up, and cancers from different parts of the body can be similar.
New research will inform esophageal cancer clinical trials
This current study could lead to more informed clinical trials for esophageal cancer in which treatments are given according to the genetic features of the tumour. Clinical trials generally enroll patients who have cancer in the same tissue type, and these patients receive the same treatment approach.
This study has the potential to greatly expand the number of new therapies for esophageal cancer and bring the right treatment to the right patient. Hopefully, with further research, we can ultimately improve the survival of patients with esophageal cancer.
Kelly Fathers, PhD