Targeted medications are one of several options used to stop or slow the spread of esophageal cancer. Doctors often prescribe these medications alongside other treatments like surgery, chemotherapy, and radiation.
Esophageal cancer treatment includes standard cancer treatments such as surgery to remove the tumor. It also includes chemotherapy and radiation to kill cancer cells and shrink the tumor.
In recent years, targeted therapy medications have also become a major part of esophageal cancer treatment.
Targeted medications can find cancer cells and interfere with how they work. This can stop or slow the spread of esophageal cancer. Research has found targeted therapy to be effective when used alongside another treatment, such as chemotherapy.
This article takes a closer look at the types of targeted medications doctors prescribe to treat esophageal cancer, how they work, and the potential side effects.
Trastuzumab (Herceptin) targets a protein called human epidermal growth factor receptor 2 (HER2). Doctors prescribe this medication for people with esophageal cancer. This is because HER2 can help esophageal cancer cells grow. And high levels of this protein are sometimes seen in esophageal cancer cells.
Trastuzumab finds HER2 proteins and interferes with their function. This can slow down cancer.
Usually, trastuzumab is given through an intravenous (IV) infusion. You’ll receive it once every three weeks. You might have chemotherapy at the same time.
Fam-trastuzumab deruxtecan (Enhertu) also targets the HER2 protein, but it works directly with chemotherapy. This targeted medication acts as a guide or map for chemotherapy, leading it right to cancer cells. The medication attaches itself to the HER2 proteins so that chemotherapy treatment can directly find and eliminate the HER2 protein.
Usually, you’ll receive fam-trastuzumab deruxtecan through an IV once every three weeks.
Ramucirumab (Cyramza) targets a protein called vascular endothelial growth factor (VEGF). Doctors prescribe this medication for esophageal cancers that develop where the esophagus and stomach meet.
VEGF helps provide nutrients to esophageal tumors and tells cancer cells to produce blood vessels. Ramucirumab prevents VEGF from joining with cancer cells and can slow or stop cancer spread.
Typically, you’ll receive ramucirumab through an IV once every two weeks.
Sometimes, people with esophageal cancer have genes that have fused together, leading to abnormal cell growth. The targeted medications entrectinib (Rozlytrek) and Larotrectinib (Vitrakvi) target this abnormal gene fusion.
Doctors often refer to these medications as tropomyosin receptor kinase (TRK) inhibitors. This is because the abnormal fusion starts with the NTRK gene. Doctors usually prescribe these medications for people who have this gene fusion and a tumor that can’t be surgically removed. They may also prescribe these medications for people who have esophageal cancer that has spread and come back.
You’ll take entrectinib and larotrectinib once a day in capsule or pill form.
Potential side effects
Potential side effects include:
- a cough
Targeted medications are one of several options used to treat esophageal cancer. Typically, doctors may recommend multiple treatments as part of a complete treatment plan.
Your exact treatment plan will vary depending on factors such as:
- your stage at diagnosis
- type of esophageal cancer
- tumor location
- your response to treatment
Doctors recommend chemotherapy to shrink tumors and kill cancer cells. In esophageal cancer, doctors may recommend chemotherapy before tumor-removal surgery, after surgery, or in later stages to treat symptoms.
People with esophageal cancer receive chemotherapy in cycles that usually last between 3 and 6 months. It can be given at the same time as other treatments, including radiation and targeted therapy.
Radiation is used to kill cancer cells. It can also help shrink tumors before tumor-removal surgery. It’s often used at the same time as chemotherapy.
Doctors perform surgery to remove the tumor. The exact procedure depends on the location and size of your tumor. Sometimes, only part of your esophagus might need removal. But in other cases, the entire esophagus along with the nearby lymph nodes will need removal.
Chemoradiation is treatment with radiation and chemotherapy at the same time. It allows you to get the benefits of two proven cancer treatments at once.
Immunotherapy can help increase the body’s immune response, making cancer treatment more effective. Additionally, it can teach your immune system to find and fight cancer cells. This can help treat some forms of esophageal cancer.
Photodynamic therapy (PDT)
Photodynamic therapy (PDT) is sometimes called light therapy. This treatment uses light to kill early-stage cancers. Sometimes, this treatment alone is enough to help treat esophageal cancer for people who have very small early-stage tumors. Doctors may also recommend PDT along with options, such as chemotherapy or radiation.
Radiofrequency ablation (RFA)
Radiofrequency ablation (RFA) uses extreme heat to destroy tumors. This treatment is minimally invasive and is often an option for people who can’t have surgery.
Cryotherapy uses very cold temperatures to freeze and destroy tumors. It’s sometimes a good choice for people who have tumors that can’t be removed with surgery or for those who aren’t good candidates for surgery.
Several targeted medications are used to target esophageal cancer cells. Doctors usually prescribe these medications alongside other treatments, such as surgery, chemotherapy, or radiation.
For example, targeted therapy medications can slow down or stop the spread of cancer, while a treatment such as chemotherapy kills cancer cells.
Targeted therapy medications can have side effects, and although most are mild, some can be severe. Your medical team will monitor you for these side effects during your treatment.