Genomic alterations in advanced esophageal cancer may lead to subtype-specific therapies

Patrick Forde, Ronan Joseph Kelly

Research output: Contribution to journalArticle

Abstract

The development of targeted agents for metastatic esopha-geal or gastroesophageal junction (GEJ) tumors has been lim-ited when compared with that for other common tumors. To date, the anti-human epidermal growth factor receptor-2 (HER-2) antibody, trastuzumab, in combination with chemo-therapy, is the only approved novel agent for these cancers, and its use is limited to the small population of patients whose tumors overexpress HER-2. Despite recent progress in the field, median overall survival remains only 8-12 months for patients with stage IV esophageal or GEJ cancer. In this article, we examine the molecular aberrations thought to drive the development and spread of esophageal cancer and identify promising targets for specific tumor inhibition. Data from clin-ical studies of targeted agents are reviewed, including epider-mal growth factor receptor antibodies, tyrosine kinase inhibitors, HER-2, and vascular endothelial growth factor-directed therapy. Current and future targets include MET, fibro-blast growth factor receptor, and immune-based therapies. Evidence from trials to date suggests that molecularly unse-lected patient cohorts derive minimal benefit from most tar-get-specific agents, suggesting that future collaborative investigation should focus on preselected molecular sub-groups of patients with this challenging heterogeneous disease.

Original languageEnglish (US)
Pages (from-to)823-832
Number of pages10
JournalOncologist
Volume18
Issue number7
DOIs
Publication statusPublished - Jun 2013

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Keywords

  • Esophageal cancer
  • Genomic
  • HER2
  • Mutation
  • Novel
  • Targeted
  • Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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