Introduction: Esophageal cancer (EC) is the seventh most common cancer and the sixth leading cause of cancer death. However, the prognosis of unresectable advanced or recurrent EC patients remains poor and there are few effective therapeutic agents for EC. Pembrolizumab is a monoclonal antibody that exerts anti-tumor activity by inhibiting the interaction of programmed cell death protein 1 with its ligand (PD-L1) on activated lymphocytes. Pembrolizumab monotherapy shows a significant survival benefit in metastatic or recurrent EC patients with PD-L1 CPS ≥10 as second-line treatment.
Area covered: In this review, we provide an overview of pembrolizumab as a compound and present the available clinical data related to EC treatment.
Expert opinion: In our opinion, pembrolizumab is one of the standard treatment agents for second-line metastatic or recurrent esophageal squamous cell carcinoma patients with PD-L1 CPS ≥10. Trials assessing the efficacy of a combination of cytotoxic agents and pembrolizumab as first-line treatment and pembrolizumab-containing chemoradiation are ongoing. Their results may provide important data to improve clinical outcomes.
Keywords: Combined positive score (CPS); esophageal adenocarcinoma (EAC); esophageal carcinoma (EC); esophageal squamous cell carcinoma (ESCC); immune checkpoint inhibitor; pembrolizumab; programmed death ligand-1 (PD-L1).