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In Silico Clinical Trials for Cardiovascular Disease
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Clinical Trials Update in Resectable Esophageal Cancer.
Aaron J Dinerman1, Shamus R Carr2
1Department of Surgery, Baylor University Medical Center, Dallas, TX 75246, USA.
Cancers
|January 28, 2026
Summary
Perioperative chemotherapy, particularly the FLOT regimen, shows improved survival for esophageal cancer over chemoradiotherapy. Advances include immunotherapy and minimally invasive surgery, enhancing treatment options.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Oncology
Background:
- Esophageal cancer management has shifted to a multidisciplinary approach.
- Induction chemoradiotherapy was the standard for locally advanced disease, improving resection and survival rates.
- Recent trials challenge this standard, exploring perioperative chemotherapy and immunotherapy.
Purpose of the Study:
- To review the evolution of treatment for resectable esophageal cancer.
- To summarize evidence from key clinical trials.
- To discuss current and future therapeutic strategies, including immunotherapy.
Main Methods:
- Review of pivotal clinical trials (CROSS, ESOPEC, MATTERHORN).
- Analysis of systemic therapy advancements (perioperative chemotherapy, immunotherapy).
- Examination of surgical technique evolution (minimally invasive, robotic-assisted esophagectomy).
Main Results:
- Perioperative FLOT chemotherapy demonstrated superior survival and systemic disease control compared to chemoradiotherapy for esophageal adenocarcinoma.
- Addition of durvalumab to FLOT chemotherapy improved event-free survival.
- Minimally invasive and robotic-assisted esophagectomy offer comparable oncologic outcomes with reduced morbidity.
Conclusions:
- Perioperative chemotherapy represents a significant advancement in esophageal cancer treatment.
- Immunotherapy integration and minimally invasive surgical techniques are further refining patient care.
- Emerging strategies like adoptive cell transfer hold future promise for managing esophageal cancer, including metastatic recurrence.
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