Developments in Treatment of Esophageal/Gastric Cancer

Abstract

Advances have been achieved in the therapy of esophageal and gastric cancer (including carcinoma of gastroesophageal junction); however, it poses a continuous challenge to treat this highly virulent disease effectively. The concept of the benefits of perioperative (pre- or/and post-) therapy (chemotherapy or chemoradiation) has been accepted and confirmed by several large randomized phase III studies globally in different regions, settings, and patient population (INT 0116, MAGIC, ACTS-GC, and JCOG 9907). Efficacy of combination of newer cytotoxic chemotherapy agents has been demonstrated with increased progression-free survival and overall survival in patients with metastatic disease (e.g., REAL-2, V325, SPIRITS, and COG9912). Encouraging results have been shown from recent preliminary data with biological and target-oriented agents in the treatment of esophageal and gastric cancer.

HER-2/neuTesting and Therapy in Gastroesophageal Adenocarcinoma

“…Therapies directed against VEGF(R) are the focus of ongoing research in many malignancies including gastroesophageal cancer [98, 99]. Bevacizumab, a monoclonal anti-VEGF antibody, has been investigated in the locally advanced and metastatic first- and second-line setting with encouraging phase II results [96].…”

MAGIC in practice: Experience of peri‐operative ECF/X chemotherapy in gastro‐esophageal adenocarcinomas

“…However, the mortality rate is high with 12,784 patients dying from esophago‐gastric cancer in 2008 together making them the third most common cause of cancer death after lung and colorectal cancer 1. The incidence of esophageal squamous cell cancer is reducing whereas the incidence of esophageal adenocarcinoma is rapidly increasing in the United Kingdom, USA and other western countries 2. There has also been a worldwide increase in cancers of the proximal stomach and gastro‐esophageal junction (GEJ) 2 but a decrease in the proportion of distal gastric cancers 3, 4.…”

“…The incidence of esophageal squamous cell cancer is reducing whereas the incidence of esophageal adenocarcinoma is rapidly increasing in the United Kingdom, USA and other western countries 2. There has also been a worldwide increase in cancers of the proximal stomach and gastro‐esophageal junction (GEJ) 2 but a decrease in the proportion of distal gastric cancers 3, 4. Until recently, surgery alone has been the treatment of choice for all resectable esophageal, GEJ and gastric cancers.…”

The function and mechanism of COX-2 in angiogenesis of gastric cancer cells

“…The treatment outcome of this common malignancy is still not satisfactory and various chemotherapeutic attempts in an adjuvant setting have failed to improve the survival rate in gastric cancer. Recently, angiogenesis has been found related to hematogenous recurrence and poor prognosis in gastric cancer [1]. Angiogenesis is the growth of new vessels from existing vasculature.…”