Molecular biological challenges in he treatment of esophageal adenocarcinoma.
Despite improvements in detection and treatment, patients diagnosed with esophageal cancer continue to have a poor prognosis, with an increase in 5-year survival rates from 6 to 16% over the past 25 years. In the last decade there has been growing support for neoadjuvant therapy in patients with esophageal cancer. However, in approximately 30-60% of the patients no objective response is achieved after neoadjuvant chemotherapy and/or radiotherapy. These patients do not benefit from neoadjuvant therapy but do suffer from toxic side effects, and appropriate surgical treatment is delayed. Advances in molecular biology and new molecular technologies could possibly contribute to improvement of response to neoadjuvant therapy. This review categorizes the genetic and molecular alterations related to esophageal adenocarcinoma and links these changes to targeting therapy and prediction of tumor response to neoadjuvant chemotherapy and/or radiotherapy.
Boonstra
Jurjen J
JJ
University Medical Center Rotterdam, Department of Surgery, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands. j.j.boonstra@erasmusmc.nl
Dinjens
Winand Nm
WN
Tilanus
Hugo W
HW
Koppert
Linetta B
LB
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics* / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000532:radiotherapy; D006801:Humans