Emerging First-Line Treatment Options for Locally Advanced or Metastatic Esophageal Squamous Cell Carcinoma (ESCC)

Nabil Saba, MD, FACP and Harry Yoon, MD, briefly review the incidence of esophageal squamous cell carcinoma (ESCC), and describe how many patients present with unresectable locally advanced or metastatic disease in their clinical practice.

Expert perspectives on the process of biomarker testing, including PD-L1 testing, for patients with unresectable locally advanced or metastatic ESCC.

Drs Saba and Yoon share how a patient’s biomarker testing results typically affect prognosis and how they may influence subsequent treatment decision-making.

A focused discussion on the available first-line treatment options for advanced/metastatic ESCC.

Drs Saba and Yoon share the factors they consider when choosing among available first-line regimens for ESCC, including clinical trial data and the patient’s PD-L1 expression status.

Dr Yoon introduces tislelizumab, an anti-PD-1 immunotherapy regimen being investigated as a first-line ESCC treatment option in combination with chemotherapy, and discusses recent conference data from the RATIONALE-306 trial.

Drs Saba and Yoon reflect on how the potential FDA approval and availability of tislelizumab might change first-line ESCC treatment paradigms in the future.

A review of other ongoing trials and emerging treatment regimens in the space and a summary of takeaways from trials on other squamous cell cancers that may also be applied to ESCC.

Closing out their conversation, Drs Saba and Yoon share their hopes for the future of ESCC, including elucidating the molecular mechanisms behind immune evasion and treatment response to chemotherapy, radiation, and immunotherapy.