Harnessing biomarkers of response to improve therapy selection in esophago-gastric adenocarcinoma

Advanced esophago-gastric (OG) adenocarcinomas have a high mortality rate and new therapeutic options are urgently required. Despite recent advances in understanding the molecular characteristics of OG cancers, tumor heterogeneity poses a challenge in developing new therapeutics capable of improving...

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Bibliographic Details
Published in:Pharmacogenomics 2021-07, Vol.22 (11), p.703-726
Main Authors: Fong, Caroline Yk, Chau, Ian
Format: Article
Language:English
Subjects:
Adenocarcinoma - genetics
Adenocarcinoma - metabolism
Adenocarcinoma - therapy
Biomarkers - metabolism
biomarkers of response
Biomarkers, Tumor - genetics
Biomarkers, Tumor - metabolism
Camptothecin - administration & dosage
Camptothecin - analogs & derivatives
esophageal cancer
Esophageal Neoplasms - genetics
Esophageal Neoplasms - metabolism
Esophageal Neoplasms - therapy
esophago-gastric adenocarcinoma
gastric cancer
gastro-esophageal junction cancer
Humans
Immune Checkpoint Inhibitors - administration & dosage
Immunoconjugates - administration & dosage
Immunotherapy - methods
Immunotherapy - trends
Precision Medicine - methods
Precision Medicine - trends
precision oncology
predictive biomarkers
Receptor, ErbB-2 - genetics
Receptor, ErbB-2 - metabolism
Review
Stomach Neoplasms - drug therapy
targeted therapy
Trastuzumab - administration & dosage
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Description
Summary:Advanced esophago-gastric (OG) adenocarcinomas have a high mortality rate and new therapeutic options are urgently required. Despite recent advances in understanding the molecular characteristics of OG cancers, tumor heterogeneity poses a challenge in developing new therapeutics capable of improving patient outcomes. Consequently, chemotherapy remains the mainstay of systemic treatment, with the HER2 being the only predictive biomarker routinely targeted in clinical practice. Recent data indicate that immunotherapy will be incorporated into first-line chemotherapy, but further research is required to refine patient selection. This review will summarize the clinical strategies being evaluated to utilize our knowledge of predictive biomarkers with reference to novel therapeutics, and discuss the barriers to implementing precision oncology in OG adenocarcinoma.
ISSN:1462-2416
1744-8042
DOI:10.2217/pgs-2020-0090