Dr. Kais Zakharia highlighted ESD as a curative alternative to surgery for T1A esophageal cancer, offering >95% 5-year survival, lower mortality, and excellent outcomes with multidisciplinary care and AI support.

Radiation remains important in select esophageal cancers. CROSS and CheckMate 577 improved outcomes, while FLOT and immunotherapy are reshaping care, especially for MSI-high disease.

Dr. David Ilson reviewed biomarker-driven esophageal cancer care, highlighting HER2, MSI, and CLDN18.2 testing, HER2-targeted therapies, checkpoint inhibitors, and emerging HER3/EGFR ADCs.

Experts discussed treatment options for biomarker-negative disease, emerging bispecifics, ADCs, CAR T, sentinel node mapping, peritoneal metastases, and selective nonoperative management.