Esophageal cancerthe devastating disease that took Robert Kardashian's life along with more than 16,000 others this year alonehas a new treatment option: immunotherapy.
The U.S. Food and Drug Administration (FDA) has just approved the promising immunotherapy drug pembrolizumab (known by its brand name, "Keytruda") to treat patients with a certain type of advanced esophageal cancer called "squamous cell carcinoma." The people that will benefit from this new drug are the ones whose stubborn cancers haven't responded to other treatments they've tried first, such as chemotherapy.
Read MoreDr. Cheng is right; esophageal cancer is a very difficult diagnosis. For the advanced stages of esophageal cancer, doctors usually turn to conventional chemotherapy. But this chemo is largely used to relieve pain; historically, it hasn't been shown to have long-term benefits. Only 5 percent of all patients with advanced esophageal cancermeaning cancer that has spread beyond the esophagus to other parts of the bodysurvive for 5 years.
Dr. Raja Flores, Chairman of Thoracic Surgery at Mount Sinai School of Medicine, previously explained to SurvivorNet that the two biggest causes of esophageal cancer are smoking and acid reflux (heartburn). Over 17,500 people were diagnosed with esophageal cancer in 2019, and about 16,000 people died from the disease.
What is Immunotherapy, and How Does Keytruda Work?
Immunotherapy drugs, which allow the body's own immune system to attack cancer cells, have been lauded as miracle drugs since they were first approved to treat melanoma in 2011, and have become a beacon of hope today.
Keytruda, which is a type of immunotherapy drug called a checkpoint inhibitor, works by blocking a "don't attack me" signal on cancer cellsmaking it so that the cancer cells no longer get ignored by the immune system.
RELATED: Immunotherapy For Esophageal Cancer Has It Worked?
"It's a Jedi mind trick that tells the immune system 'move on by ignoring me,'" Dr. Geoffrey Oxnard, a thoracic oncologist at Dana-Farber Cancer Institute, previously explained to SurvivorNet "If we block that signal, the immune system wakes up, sees the cancer, and attacks."
With Keytruda in particular, this signal is a protein called PD-L1, and it's important, because the "specific group" of esophageal cancer patients that saw the greatest benefit from this drug in the clinical trials were those who had a lot of PD-L1 in their cancer. Accordingly, the FDA approved the drug to treat these patientsthat is, the ones whose esophageal cancer tumors express a certain amount of PD-L1.
Immunotherapy is Expanding
The FDA has been approving these new and promising drugs for a growing list of cancersmaking more patients eligible for their benefits. According to the latest research, the percentage of patients eligible for checkpoint inhibitors has increased to 43 percent since 2011, and the percent of patients who respond to these drugs rose to 12 percent.
"It's not just hype it's here to stay," Dr. Brendon Stiles, Thoracic Surgeon at Weill Cornell Medicine and NewYork-Presbyterian told SurvivorNet in a conversation about the expanded use of immunotherapy. "It's really changed the paradigm."
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