One of the reasons cancer is so hard to treat is that the body struggles to recognise cancer cells and kill them. Immunotherapy is a relatively new approach to treating cancer. Medication is designed to improve the body’s own ability to find and kill cancer cells.

Cancer cells can often have high numbers of the same molecule on their surface. Immunotherapy drugs called monoclonal antibodies can bind to these molecules and allow the body’s immune system to recognise them as cancer. Several immunotherapy drugs are being trialed in oesophageal cancer.

Unfortunately, not all immunotherapies work for all cancers. Researchers are developing tests that will enable doctors to know which drugs will help treat which tumours.

In the past, studies have treated all oesophageal cancer as though it is one disease. It is, however, becoming increasingly clear that oesophageal cancer is far more complex than that. Some small groups of patients do much better than other groups using standard therapy.

The next generation of clinical trials will involve stratification of patients according to the molecular features of their tumours and their predicted response to therapy.

Immunotherapy is likely to transform the way we think about oesophageal cancer. The increase in survival and reduction in side effects means there is a great deal of optimism and hope for patients, relatives, carers, and those involved in treating oesophageal cancer. Research funded and supported by charities such as Heartburn Cancer UK are developing a new wave of intelligent, precision-guided treatments in the fight against cancer.