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NCCN Guidelines for Patients


Esophageal Cancer, Version 1.2016


Overview of cancer treatments Targeted therapy | Clinical trials

HER2 pathway

Cell growth is started by growth signals. HER2 is one

of the surface receptors in esophageal cancer cells

that can trigger growth signals. When HER2 attaches

to other receptors, the chemical pathway that sends

growth signals is turned on.

Some people with esophageal cancer have too many

HER2s. With too many HER2s, new cancer cells form

quickly. Trastuzumab is a medicine used to stop the

growth signals from HER2s.


Trastuzumab attaches to the end of HER2 that is

outside of the cell. In doing so, it stops HER2 from

attaching to other surface receptors.

See Figure 15


No growth signals are started.

Trastuzumab is given with chemotherapy. It is given

as an injection into a vein. The drug then travels in

the bloodstream to treat cancer throughout the body.

You may have a mild flu-like response to the first dose

of trastuzumab that includes fever, chills, headache,

muscle aches, and nausea. This response is less

common with the second and third doses. Rare side

effects include damage to the heart or lungs.

Clinical trials

New tests and treatments aren’t offered to the

public as soon as they’re made. They first need to

be studied. A clinical trial is a type of research that

studies a test or treatment.

Clinical trials study how safe and helpful tests and

treatments are. When found to be safe and helpful,

they may become tomorrow’s standard of care.

Because of clinical trials, the tests and treatments in

this book are now widely used to help people with

esophageal cancer. Future tests and treatments that

may have better results than today’s treatments will

depend on clinical trials.

Figure 15.

HER2 targeted therapy

Some esophageal cancers

consist of cancer cells with too

many HER2s. HER2s trigger

growth signals with cancer

cells. Trastuzumab blocks HER2

from attaching to other surface

receptors and starting growth


Copyright © 2016 National Comprehensive Cancer Network® (NCCN®).

cancer cell

HER2 receptor