Challenges and perspectives for immunotherapy in oesophageal cancer: A look to the future (Review)

Abstract

Oesophageal cancer is one of the most aggressive malignancies with limited treatment options, thus resulting in a high morbidity and mortality. With 5‑year survival rates of only 5‑10%, oesophageal cancer holds a dismal prognosis for patients. In order to improve overall survival, the early diagnosis and tools for patient stratification for personalized treatment are urgent needs. A minority of oesophageal cancers belong to the spectrum of Lynch syndrome‑associated cancers and are characterized by microsatellite instability (MSI). Microsatellite instability is a consequence of defective mismatch repair protein functions and it has been well characterized in other gastrointestinal tumours, such as colorectal and gastric cancer. In the latter, high levels of MSI are associated with a better prognosis and with an increased benefit to immune‑based therapies. Therefore, similar therapeutic approaches could offer an opportunity of treatment for oesophageal cancer patients with MSI. Apart from immune checkpoint inhibitors, other immunotherapies such as adoptive T‑cell transfer, peptide vaccine and oncolytic viruses are under investigation in oesophageal cancer patients. In the present review, the rationale and current knowledge about immunotherapies in oesophageal cancer are summarised.

Keywords: immunotherapy; oesophageal cancer; immune checkpoint inhibitors; adoptive T‑cell therapy; peptide vaccine; oncolytic viruses.

Figure 1

Immunotherapy approaches in oesophageal cancer. Illustration of the different immunotherapy approaches that have been studied thus far in the context of oesophageal cancer. CAR, chimeric antigen receptor; TCR, T-cell receptor; IL-2, interleukin 2.