Precision Oncology in Gastro-Esophageal Adenocarcinoma
Gastro-esophageal adenocarcinomas (GEA) are a leading cause of cancer mortality, with limited therapeutic strategies available. With the advent of next-generation sequencing (NGS) and novel technologies, our understanding of its pathogenesis and molecular characterization continues to be improved, a...
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| Format: | Article |
| Language: | English |
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THE HEALTHBOOK COMPANY LTD.
2020-10-01
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| Series: | healthbook TIMES. Oncology Hematology |
| Online Access: | https://doi.org/10.36000/hbT.OH.2020.05.018 |
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| author | Marco Cefalì Celeste Palmarocchi Sara De Dosso |
| author_facet | Marco Cefalì Celeste Palmarocchi Sara De Dosso |
| author_sort | Marco Cefalì |
| collection | DOAJ |
| description | Gastro-esophageal adenocarcinomas (GEA) are a leading cause of cancer mortality, with limited therapeutic strategies available. With the advent of next-generation sequencing (NGS) and novel technologies, our understanding of its pathogenesis and molecular characterization continues to be improved, and new biomarkers have been identified. The onset and progression of gastric cancer has been attributed to multiple factors, including genetic alterations, epigenetic modifications, Helicobacter pylori, and Epstein-Barr Virus (EBV) infection, and dietary habits. These advances permit to integrate clinical, genetic, and epigenetic changes, and apply them to individual GEA patients in the era of precision medicine. Some biomarker-driven strategies are already part of consolidated clinical practice, proving the feasibility of this approach in principle, as is the case with the use of trastuzumab in human epidermal growth factor receptor 2 (HER2)-expressing GEA. Others, namely in the setting of immunotherapy and targeted therapy, are still investigational and require further study. The treatment of GEA is no longer defined by a “one size fits all” approach, and the definition of molecular subgroups amenable to individualized treatment strategies is likely the way forward. However, the lack of standardization and the multiplication of proposed classifications and biomarkers represents a significant obstacle to establishing a new paradigm. While small-scale experiences are undoubtedly of value and essential for hypothesis generation, appropriately powered prospective clinical trials are now urgently needed to translate these hypotheses in evidence-based practice. In this review, we will discuss the current and future potential biomarkers, drugs, and therapeutic approaches available for the management of GEA patients. |
| format | Article |
| id | doaj-art-dfcd5744b0c241c7b8fd7b53458db97b |
| institution | DOAJ |
| issn | 2673-2092 2673-2106 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | THE HEALTHBOOK COMPANY LTD. |
| record_format | Article |
| series | healthbook TIMES. Oncology Hematology |
| spelling | doaj-art-dfcd5744b0c241c7b8fd7b53458db97b2025-08-20T03:14:40ZengTHE HEALTHBOOK COMPANY LTD.healthbook TIMES. Oncology Hematology2673-20922673-21062020-10-015310.36000/hbT.OH.2020.05.018Precision Oncology in Gastro-Esophageal AdenocarcinomaMarco CefalìCeleste PalmarocchiSara De DossoGastro-esophageal adenocarcinomas (GEA) are a leading cause of cancer mortality, with limited therapeutic strategies available. With the advent of next-generation sequencing (NGS) and novel technologies, our understanding of its pathogenesis and molecular characterization continues to be improved, and new biomarkers have been identified. The onset and progression of gastric cancer has been attributed to multiple factors, including genetic alterations, epigenetic modifications, Helicobacter pylori, and Epstein-Barr Virus (EBV) infection, and dietary habits. These advances permit to integrate clinical, genetic, and epigenetic changes, and apply them to individual GEA patients in the era of precision medicine. Some biomarker-driven strategies are already part of consolidated clinical practice, proving the feasibility of this approach in principle, as is the case with the use of trastuzumab in human epidermal growth factor receptor 2 (HER2)-expressing GEA. Others, namely in the setting of immunotherapy and targeted therapy, are still investigational and require further study. The treatment of GEA is no longer defined by a “one size fits all” approach, and the definition of molecular subgroups amenable to individualized treatment strategies is likely the way forward. However, the lack of standardization and the multiplication of proposed classifications and biomarkers represents a significant obstacle to establishing a new paradigm. While small-scale experiences are undoubtedly of value and essential for hypothesis generation, appropriately powered prospective clinical trials are now urgently needed to translate these hypotheses in evidence-based practice. In this review, we will discuss the current and future potential biomarkers, drugs, and therapeutic approaches available for the management of GEA patients.https://doi.org/10.36000/hbT.OH.2020.05.018 |
| spellingShingle | Marco Cefalì Celeste Palmarocchi Sara De Dosso Precision Oncology in Gastro-Esophageal Adenocarcinoma healthbook TIMES. Oncology Hematology |
| title | Precision Oncology in Gastro-Esophageal Adenocarcinoma |
| title_full | Precision Oncology in Gastro-Esophageal Adenocarcinoma |
| title_fullStr | Precision Oncology in Gastro-Esophageal Adenocarcinoma |
| title_full_unstemmed | Precision Oncology in Gastro-Esophageal Adenocarcinoma |
| title_short | Precision Oncology in Gastro-Esophageal Adenocarcinoma |
| title_sort | precision oncology in gastro esophageal adenocarcinoma |
| url | https://doi.org/10.36000/hbT.OH.2020.05.018 |
| work_keys_str_mv | AT marcocefali precisiononcologyingastroesophagealadenocarcinoma AT celestepalmarocchi precisiononcologyingastroesophagealadenocarcinoma AT saradedosso precisiononcologyingastroesophagealadenocarcinoma |