From Tumor Immunology to Immunotherapy in Gastric and Esophageal Cancer

Abstract

Esophageal and gastric cancers represent tumors with poor prognosis. Unfortunately, radiotherapy, chemotherapy, and targeted therapy have made only limited progress in recent years in improving the generally disappointing outcome. Immunotherapy with checkpoint inhibitors is a novel treatment approach that quickly entered clinical practice in malignant melanoma and renal cell cancer, but the role in esophageal and gastric cancer is still poorly defined. The principal prognostic/predictive biomarkers for immunotherapy efficacy currently considered are PD-L1 expression along with defects in mismatch repair genes resulting in microsatellite instability (MSI-H) phenotype. The new molecular classification of gastric cancer also takes these factors into consideration. Available reports regarding PD-1, PD-L1, PD-L2 expression and MSI status in gastric and esophageal cancer are reviewed to summarize the clinical prognostic and predictive role together with potential clinical implications. The most important recently published clinical trials evaluating checkpoint inhibitor efficacy in these tumors are also summarized.

The Combination Options and Predictive Biomarkers of PD-1/PD-L1 Inhibitors in Esophageal Cancer

“…PD-L1 overexpression has been reported in around 40% of EC patients and is related to worse OS (11). Various methods could be used to detect PD-L1 expression in different cancers, including immunohistochemistry (IHC) staining, enzyme-linked immunosorbent assay (ELISA), immunofluorescence (IF), flow cytometry (FC) and so on.…”

High SLC17A9 Expression Correlates with Poor Survival in Gastric Carcinoma

“…GC imposes huge economic burdens on many families and countries [3]. Although advances in diagnosis and treatment have improved survival rates of patients with early GC [2], there is no effective treatment for patients with advanced GC, including targeted and immunotherapies [4]. Thus, a better understanding of the molecular mechanism of GC development may help us devise new therapeutic strategies and improve the prognosis of GC patients.…”

Complications of the surgical treatment of esophageal cancer and microbiological analysis of the respiratory tract

“…Paralysis of the left reccurent laryngeal nerve in patients operated on using the cervical approach is reported in up to 14% of patients 35 . There is a consensus that is based on the analysis of postoperative results that surgery for esophageal cancer should be performed in high volume centres 36, however despite this effort and intensive research in this field [37][38][39] the general outcome of the treatment remains unsatisfactory. The present retrospective analysis has some obvious limitations.…”