Abstract
Esophageal cancer (EC) is a common malignant tumor with poor prognosis, and current treatments for patients with advanced EC remain unsatisfactory. Recently, immunotherapy has been recognized as a new and promising approach for various tumors. EC cells present a high tumor mutation burden and harbor abundant tumor antigens, including tumor-associated antigens and tumor-specific antigens. The latter, also referred to as neoantigens, are immunogenic mutated peptides presented by major histocompatibility complex class I molecules. While current genomics and bioinformatics technologies have greatly facilitated the identification of tumor neoantigens, identifying individual neoantigens systematically for successful therapies remains a challenging problem. Owing to the initiation of strong, specific tumor-killing cytotoxic T cell responses, neoantigens are emerging as promising targets to develop personalized treatment and have triggered the development of cancer vaccines, adoptive T cell therapies, and combination therapies. This review aims to give a current understanding of the clinical application of neoantigens in EC and provide direction for future investigation.
Highlights
EC ranks as the seventh most common malignant tumor and the sixth leading cause of cancerrelated death worldwide
Chemotherapy or radiotherapy might facilitate effector T cell infiltration by eliciting tumor tissue to release more antigens [52, 54]. Another actionable approach involves the use of neoantigen-specific immunotherapy and PD-1 or PD-L1 inhibitor therapy
The rationale for this combination is that blocking active checkpoints might reactivate T cell function [70]
Summary
EC ranks as the seventh most common malignant tumor and the sixth leading cause of cancerrelated death worldwide. Ishihara et al tested a combination therapy of CHP-NY-ESO-1 cancer vaccine and an anti-PD-1 monoclonal antibody and induced significant tumor suppression (P = 0.029) compared with the no-treatment group [27]. This combination therapy is a promising strategy and merits future attention. It has been reported that a tumor-specific vaccine combined with immune checkpoint therapy can lead to a more efficient response than monotherapy in pancreatic and prostate cancer in preclinical comparative studies [50, 51]. Approaches to integrate chemoradiotherapy with immunotherapy provide novel therapeutic strategies and are in the ascendance
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