What Will We Expect From Novel Therapies to Esophageal and Gastric Malignancies?

Am Soc Clin Oncol Educ Book. 2018 May 23;38:249-261. doi: 10.1200/EDBK_198805.

Abstract

Esophageal cancer and gastric cancer are aggressive diseases for which treatment approaches are facing a new era. Some molecular pathways, such as VEGF, EGFR, fibroblast growth factor receptor, PIK3CA, and PARP-1, have been studied, and novel targeted drugs are presumed to be developed in the near future. From The Cancer Genome Atlas report, 80% of Epstein-Barr virus tumors and 42% of tumors with microsatellite instability have PIK3CA mutations, suggesting that this pathway could be reevaluated as a possible target for new systemic treatment of gastric cancer. Notably, higher PARP-1 expression can be found in gastric cancer, which might be related to more advanced disease and worse prognosis. In addition, PD-L1 expression, high microsatellite instability, and mismatch repair deficiency can be found in gastric cancer, thus suggesting that immunotherapy may also play a role in those patients. We discuss trends related to the potential of novel therapies for patients with esophageal and gastric cancers in the near future.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Biomarkers, Tumor
  • Esophageal Neoplasms / diagnosis
  • Esophageal Neoplasms / genetics
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / therapy*
  • Humans
  • Microsatellite Instability
  • Microsatellite Repeats
  • Mutation
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / therapy*
  • Treatment Outcome

Substances

  • Biomarkers
  • Biomarkers, Tumor