Hello everyone, I’m looking for advice and insights about a case of advanced esophageal cancer. We’re trying to understand what can be done at this stage and what the likely outcomes might look like. Patient Details: Diagnosis: Moderately differentiated squamous cell carcinoma (SCC) of the esophagus, HER2-positive (confirmed via FISH report), diagnosed in early 2024. Treatment History: First-line therapy: 10 cycles of FOLFOX5 + Pembrolizumab (stopped due to progression). Second-line therapy: 10 cycles of Taxol + Pembrolizumab (initially showed mixed results). Current Status: The latest PET/CT scan (January 2025) shows significant progression of the esophageal tumor, mediastinal lymph nodes, and metastases to the liver and lungs. Planned Next Step: The doctors are considering Irinotecan as the next line of treatment. The patient has a history of cardiac issues (two heart attacks, open-heart surgery, and a stent) Questions: What are the realistic treatment options at this stage, especially given the recent progression and the patient’s cardiac history? How bad does the current situation look in terms of prognosis and quality of life? Are there additional steps we can take to manage symptoms, slow progression, or improve comfort? I can share the latest PET/CT scan report if it helps provide more clarity.
... View more
