Evolving Therapeutics for Resectable Esophageal Adenocarcinoma

Surgical resection remains the backbone of curative treatment for localized esophageal adenocarcinoma. However, resection alone carries a significant risk of recurrence and is no longer considered an acceptable approach for patients with locally advanced disease. Strategies incorporating perioperative chemotherapy, neoadjuvant chemoradiotherapy, and adjuvant immune checkpoint blockade have significantly improved survival. However, despite these advances, approximately half of all patients with locally advanced disease will experience recurrence and ultimately succumb to their disease. To overcome this innate resistance to cytotoxic therapy, novel strategies are being developed. This review discusses both evidence-based and emerging perioperative approaches and explores potential risk-adapted strategies to individualize perioperative therapy.