Why carry out this study?

The prognosis of patients with unresectable, locally advanced or metastatic esophageal squamous cell carcinoma (adv/met ESCC) remains poor in the USA.

Few studies have assessed the outcomes of patients receiving second-line (2L) therapy for adv/met ESCC.

What was learned from the study?

In this real-world analysis of electronic health records, few patients diagnosed with adv/met ESCC subsequently receive 2L (23.0%) therapy.

Treatments received by patients do not appear to adhere closely to clinical guidelines:

Relatively few patients received 1L fluoropyrimidines plus platinum therapy (30.2%), and taxanes were the most frequently received 1L regimen (54.7%).

Less than half of patients (43.0%) received 2L taxane therapy.

Median overall survival in patients receiving 2L therapy for ESCC was generally poor and was longer in patients receiving 2L taxane therapy (7.3 months) compared with 2L non-taxane therapies (5.1 months).

The low proportion of patients receiving 2L therapy, and the poor survival outcomes and short DoT seen in patients who do receive 2L therapy, highlights an urgent unmet need for efficacious, tolerable therapies for ESCC in the 2L setting.