Predictive factors for success of neo-adjuvant therapy in upper gastrointestinal cancer.
BACKGROUND
Predicting response to treatment has long been the Holy Grail of clinicians treating patients with upper gastrointestinal malignancy. The widespread use of neoadjuvant therapy for esophageal cancer has provided an added urgency to the issue and at the same time brought success a step closer because accurate response can be determined from analysis of the resected specimen.


METHODS
A search was undertaken of the Medline database for text references to neoadjuvant therapy, esophagus, stomach and predicting response. The references of these publications were further scanned for appropriate references in the text and reference lists.


RESULTS
Publications describing predictive markers to neoadjuvant therapy for esophageal cancer, which were most likely to be of clinical significance, were selected for inclusion in this report.


CONCLUSIONS
The most reliable tissue markers of response based on analysis of pretreatment biopsy specimens include P53, Ki-67, EGFR and the most impressive serum marker for monitoring response are CYFRA 21-1 and CEA. The results, however, are inconsistent, and the markers of relatively low sensitivity and none reliably identifies individual patients who will respond.
Walsh
Thomas N
TN
James Connolly Memorial Hospital, Dublin, Ireland. tnwalsh@indigo.ie
Grannell
Mark
M
Mansoor
Shabaz
S
D015415:Biomarkers / Q000097:blood; D005770:Gastrointestinal Neoplasms / Q000378:metabolism / Q000628:therapy*; D006801:Humans; D020360:Neoadjuvant Therapy; D011379:Prognosis
D015415:Biomarkers