Targeted therapy for cancer of the esophagus

As researchers have learned more about the changes in cells that cause cancer, they have been able to develop newer drugs that specifically target these changes. Targeted drugs work differently from standard chemotherapy drugs. They often have different (and less severe) side effects.

A small number of esophagus cancers have too much of a protein called HER2 on the surface of their cells. This protein may help the cancer cells to grow. Having too much of this protein is caused by having too many copies of the HER2 gene.

A drug that targets the HER2 protein, known as trastuzumab (Herceptin), may help treat these cancers when used along with chemotherapy. If you have esophageal cancer and cannot have surgery, your doctor may have your tumor biopsy samples tested for the HER2 protein or gene. Only cancers that have too much of the HER2 protein or gene are likely to be affected by this drug.

Trastuzumab is given by injection into a vein (IV) once every 3 weeks along with chemo. The optimal length of time to give it is not yet known.

Most of the side effects of trastuzumab are relatively mild and may include fever and chills, weakness, nausea, vomiting, cough, diarrhea, and headache. These occur less often after the first dose. Less often, this drug can cause heart damage, leading to the heart muscle becoming weak. That is why this drug is not often given with certain chemo drugs called anthracyclines, such as epirubicin (Ellence) or doxorubicin (Adriamycin), because it may further increase the risk of heart damage if they are given together. Before starting treatment with this drug, your doctor may check a test of your heart function, such as an echocardiogram or a MUGA.