title: Targeted therapy for advanced esophagogastric adenocarcinoma.
abstract: BACKGROUND
  Esophagogastric adenocarcinoma (EGC) is a molecular heterogeneous disease, and therefore, strategies with targeted therapy may be effective.
  
  
  OBJECTIVE
  This review will discuss phase III studies in advanced EGC concerning biologic agents targeting molecular pathways, such as EGFR, HER2, VEGFR, mTOR and c-MET.
  
  
  RESULTS
  HER2 inhibition with trastuzumab in combination with first line chemotherapy results in a significant survival benefit for HER2 positive carcinoma patients. Chemotherapy in combination with bevacizumab does not prolong survival in an unselected EGC patient cohort. Preliminary results of trials with EGFR, VEGFR and mTOR inhibitors are, thus far, disappointing in unselected patient cohorts. Promising studies in biomarker selected cohorts with HER2, EGFR and c-MET inhibitors are ongoing.
  
  
  CONCLUSIONS
  Targeted therapy in EGC is emerging. Improved insight in the biologic background of EGC is needed to improve patient selection, combine agents and discover new targets and agents. This may improve outcome for metastasized EGC patients.
authors.affiliation: Department of Medical Oncology, Academic Medical Center, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands. Electronic address: s.kordes@amc.uva.nl.
authors.forename: S
authors.initials: S
authors.lastname: Kordes
authors.affiliation: Department of Gastroenterology, National Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Cats
authors.affiliation: Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: S L
authors.initials: SL
authors.lastname: Meijer
authors.affiliation: Department of Medical Oncology, Academic Medical Center, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
authors.forename: H W M
authors.initials: HW
authors.lastname: van Laarhoven
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D058990:Molecular Targeted Therapy; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents
keywords: EGFR; Esophageal cancer; Gastric cancer; HER2; Targeted therapy; VEGFR; c-MET; mTOR