Medication for Esophageal Cancer

Chemotherapy drugs, a group of medications that treat cancer cells throughout the body, may be given alone or in combination with radiation therapy, in which beams of energy destroy cancer cells. Chemotherapy can often make radiation therapy more effective. When the two are used together, the approach is called chemoradiation.

Doctors may use chemotherapy or chemoradiation before surgery to shrink esophageal tumors. This can make surgery easier to perform and may help prevent the cancer from returning. Sometimes they use these approaches after surgery to destroy remaining cancer cells.

Chemotherapy or chemoradiation may be used for advanced cancer that has spread to distant organs, such as the liver, and in people who cannot undergo surgery because of poor health. These approaches also help manage symptoms such as pain and difficulty swallowing.

Chemotherapy drugs may be given through a vein as an intravenous (IV) infusion. Some drugs are given by mouth, depending on your ability to swallow.

Doctors may administer chemotherapy in a cycle of several days per week, for two to four weeks, followed by a week of rest to let the body recover. This cycle may be repeated several times.

Sometimes doctors prescribe chemotherapy drugs in combination with targeted drugs, which home in on cancer cells while avoiding healthy tissues. Targeted drugs usually have fewer side effects than chemotherapy drugs. They may also be used to treat esophageal cancers that no longer respond to traditional chemotherapy.

Doctors may add trastuzumab, which is given as an IV infusion, to a chemotherapy regimen. It consists of antibodies, immune system proteins that recognize foreign substances in the body, that attach to proteins found on the surface of cancer cells, interfering with their ability to function.

Trastuzumab targets the protein human epidermal growth factor receptor 2 (HER2). High levels of HER2 sometimes appear on esophageal cancer cells, helping them to grow.

Physicians use ramucirumab, given through a vein as an IV infusion, to treat esophageal cancers that start where the esophagus joins the stomach, also called the gastroesophageal junction.

Ramucirumab targets receptors on the surface of cancer cells. The receptors bind to a protein called vascular endothelial growth factor (VEGF), which tells cancer cells to make new blood vessels. This protein supplies the tumor with nutrients, helping it grow, but ramucirumab prevents it from binding to the receptors, slowing or stopping the cancer’s growth.

Our doctors can help manage common side effects of these medications, which include nausea, vomiting, diarrhea, and mouth sores. They can adjust the dosages of your medication, substitute other medications, or recommend one of our many supportive services, which can help lessen the impact of side effects.

NYU Langone doctors conduct and participate in many clinical trials, studies that evaluate the effectiveness of experimental therapies. Trials related to esophageal cancer may include testing targeted drugs, with or without chemotherapy.

You and your doctor can discuss whether one of these clinical trials is right for you.