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Cancer Cells and Metastasis / Monoclonal and Polyclonal Antibodies Research / HER2/EGFR in Cancer Research · Journal article
Current Treatment Options in Oncology · September 5, 2026
A consensus or society position rather than new primary data.
This is an expert clinician's guidance on antibody-drug conjugate selection across esophageal cancer subtypes, advocating for ADC integration after first-line chemoimmunotherapy failure. The recommendations are biomarker-stratified and reflect emerging trial data (some still in Phase III), but the source is a narrative review that does not present primary efficacy or safety data.
Journal article. Patients with advanced esophageal cancer (gastroesophageal junction adenocarcinoma, esophageal squamous cell carcinoma, and related malignancies) progressing after first-line chemoimmunotherapy..
Trastuzumab deruxtecan recommended for HER2-positive gastroesophageal junction adenocarcinoma based on superior overall survival benefit and bystander killing effect in HER2-low tumors Trophoblast cell-surface antigen 2 present in nearly 80% of gastroesophageal adenocarcinoma cases; sacituzumab tirumotecan under Phase III investigation in this setting B7-H3 overexpressed in over 90% of esophageal squamous cell carcinoma cases
No comparative analysis of toxicity profiles across ADCs; only interstitial lung disease with trastuzumab deruxtecan is highlighted
Clinicians may use this guidance to inform biomarker-directed ADC selection in the post-chemoimmunotherapy setting for esophageal cancer, while awaiting Phase III trial results for several agents and maintaining vigilance for agent-specific toxicities such as interstitial lung disease with trastuzumab deruxtecan.
Expert opinion and treatment recommendation on ADC use in esophageal cancer, not derived from primary trial data presented in this source.
Quoted from the source exactly as published.
Clinicians may use this guidance to inform biomarker-directed ADC selection in the post-chemoimmunotherapy setting for esophageal cancer, while awaiting Phase III trial results for several agents and maintaining vigilance for agent-specific toxicities such as interstitial lung disease with trastuzumab deruxtecan.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Esophageal cancer remains one of the most lethal malignancies worldwide, with particularly poor outcomes following disease progression after first-line chemoimmunotherapy. Antibody-drug conjugates (ADCs) have emerged as a transformative therapeutic class that combines the targeting precision of monoclonal antibodies with potent cytotoxic payloads, enabling selective tumor cell killing while minimizing off-target toxicity. In the management of advanced esophageal cancer, I advocate for the integration of ADCs as a therapeutic option following progression on first-line chemoimmunotherapy. For patients with human epidermal growth factor receptor 2 (HER2)-positive gastroesophageal junction adenocarcinoma, trastuzumab deruxtecan is my preferred choice based on its superior overall survival benefit and robust bystander killing effect, which also confers activity in HER2-low tumors. For HER2-negative gastroesophageal adenocarcinoma, trophoblast cell-surface antigen 2 represents a promising target given its high prevalence of moderate to strong expression in nearly 80% of cases, and sacituzumab tirumotecan is currently under phase III investigation in this setting. In esophageal squamous cell carcinoma, I recommend biomarker-guided selection among ADCs targeting B7-H3, given its overexpression in over 90% of cases. For Nectin-4-expressing tumors, enfortumab vedotin may be considered as a later-line alternative despite modest activity. Notably, the bispecific ADC targeting both epidermal growth factor receptor and human epidermal growth factor receptor 3, BL-B01D1, has demonstrated compelling efficacy in immunotherapy-refractory esophageal squamous cell carcinoma, and I consider it a breakthrough option in this subtype. For claudin-18.2-positive gastroesophageal junction adenocarcinoma, several ADCs including CMG901, IBI343, and tecotabart vedotin represent promising later-line choices. I emphasize that patient selection should be guided by validated predictive biomarkers, and treatment decisions must account for distinctive toxicity profiles, particularly interstitial lung disease with trastuzumab deruxtecan. Finally, I strongly support advancing ADCs into earlier lines of therapy and perioperative settings through well-designed clinical trials to further improve long-term outcomes in this aggressive malignancy.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.