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ABSTRACT
Introduction
Esophageal cancer (EC) is the seventh most common cancer and the sixth leading cause of cancer death. However, the prognosis of unresectable advanced or recurrent EC patients remains poor and there are few effective therapeutic agents for EC. Pembrolizumab is a monoclonal antibody that exerts anti-tumor activity by inhibiting the interaction of programmed cell death protein 1 with its ligand (PD-L1) on activated lymphocytes. Pembrolizumab monotherapy shows a significant survival benefit in metastatic or recurrent EC patients with PD-L1 CPS ≥10 as second-line treatment.
Area covered
In this review, we provide an overview of pembrolizumab as a compound and present the available clinical data related to EC treatment.
Expert opinion
In our opinion, pembrolizumab is one of the standard treatment agents for second-line metastatic or recurrent esophageal squamous cell carcinoma patients with PD-L1 CPS ≥10. Trials assessing the efficacy of a combination of cytotoxic agents and pembrolizumab as first-line treatment and pembrolizumab-containing chemoradiation are ongoing. Their results may provide important data to improve clinical outcomes.
Article highlights
The prognosis of advanced esophageal cancer patients remains poor and there are few effective therapeutic agents.
Pembrolizumab is a novel human monoclonal antibody that targets programmed cell death protein 1.
Pembrolizumab monotherapy has been approved by the FDA as chemotherapy for PD-L1-positive esophageal squamous cell carcinoma patients who experienced disease progression after one or more prior lines of systemic chemotherapy.
Nivolumab which targets programmed cell death protein 1 has been approved FDA as chemotherapy for esophageal squamous cell carcinoma patients after prior fluoropyrimidine- and platinum-based systemic chemotherapy.
Combination therapies containing pembrolizumab are being evaluated.
This box summarizes the key points contained in the article.
Declaration of interest
K Kato has received research funds from ONO Pharmaceuticals and MSD, Astra Zeneca, Beigene, personal fees from Lilly. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Reviewer disclosures
One of the reviewers on this manuscript has participated on advisory boards for MSD and Servier, received lecture honoraria from Eli Lilly and Servier, is the local PI for clinical trials sponsored by BMS and Astellas. Another peer reviewer on this manuscript acted as a consultant for MSD in 2018. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.