Development of new drug strategies in infrequent digestive tumors: esophageal, biliary tract, and anal cancers.
OBJECTIVE
In the last years, interesting advances have been reported in the treatment of infrequent digestive tumors. The increasing development of new targeted therapies in human cancer has also impacted in these rare gastrointestinal malignancies providing a wide range of possibilities in the design of future clinical trials.


RESULTS
The inhibition of angiogenesis and the blockage of the epidermal growth factor receptor pathway have provided the most interesting activity in recently reported studies for esophageal and biliary tract carcinomas. Additionally, several targeted therapies have been developed to target the main kinase proteins of the most important pathways of these malignancies. The results of the biggest phase III trial in locally advanced anal carcinoma have been recently published. Finally, the inhibition of epidermal growth factor receptor has also showed promising activity in anal carcinomas.


CONCLUSIONS
Recent advances in the knowledge of molecular mechanism of carcinogenesis have led to meaningful changes in the management of gastrointestinal cancers. Although the major advances in targeted therapy have been introduced in the treatment of colorectal cancer, new interesting approaches have been reported in less frequent gastrointestinal tumors such as esophageal, biliary tract, and anal canal carcinoma opening a new hope in the treatment of these rare tumors in the molecular targeted therapy era.
Capdevila
Jaume
J
Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain.
Ramos
Francisco Javier
FJ
Macarulla
Teresa
T
Elez
Elena
E
Ruiz-Echarri
Manuel
M
Perez-Garcia
Jose
J
Tabernero
Josep
J
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000098:blood supply / Q000188:drug therapy / Q000201:enzymology; D001661:Biliary Tract Neoplasms / Q000098:blood supply / Q000188:drug therapy / Q000201:enzymology; D004067:Digestive System Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000201:enzymology; D016503:Drug Delivery Systems; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D004938:Esophageal Neoplasms / Q000098:blood supply / Q000188:drug therapy / Q000201:enzymology; D006801:Humans; D009389:Neovascularization, Pathologic / Q000188:drug therapy
D020533:Angiogenesis Inhibitors; D066246:ErbB Receptors