Emerging therapeutic targets in esophageal adenocarcinoma.
The incidence of gastro-esophageal disease and associated rate of esophageal adenocarcinoma (EAC) is rising at an exponential rate in the United States. However, research targeting EAC is lagging behind, and much research is needed in the field to identify ways to diagnose EAC early as well as to improve the rate of pathologic complete response (pCR) to systemic therapies. Esophagectomy with subsequent reconstruction is known to be a morbid procedure that significantly impacts a patient's quality of life. If indeed the pCR rate of patients can be improved and those patients destined to be pCR can be identified ahead of time, they may be able to avoid this life-altering procedure. While cancer-specific biological pathways have been thoroughly investigated in other solid malignancies, much remains unexplored in EAC. In this review, we will highlight some of the latest research in the field in regards with EAC, along with new therapeutic targets that are currently being explored. After reviewing conventional treatment and current changes in medical therapy for EAC, we will focus on unchartered grounds such as cancer stem cells, genetics and epigenetics, immunotherapy, and chemoradio-resistant pathways as we simultaneously propose some investigational possibilities that could be applicable to EAC.
Department of General Surgery, Division of Thoracic Surgery, The Houston Methodist Research Institute, Houston, TX, USA.
Puja
P
Gaur
Department of Radiation Oncology, The Houston Methodist Research Institute, Houston, TX, USA.
Clayton R
CR
Hunt
Department of Radiation Oncology, The Houston Methodist Research Institute, Houston, TX, USA.
Tej K
TK
Pandita
D000230:Adenocarcinoma / Q000453:epidemiology / Q000235:genetics / Q000378:metabolism* / Q000628:therapy*; D001691:Biological Therapy / Q000379:methods / Q000639:trends; D014408:Biomarkers, Tumor / Q000032:analysis; D059248:Chemoradiotherapy / Q000379:methods / Q000639:trends; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D044127:Epigenesis, Genetic; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000378:metabolism* / Q000628:therapy*; D016629:Esophagectomy / Q000009:adverse effects*; D006801:Humans; D007167:Immunotherapy / Q000379:methods / Q000639:trends; D015994:Incidence; D058990:Molecular Targeted Therapy / Q000379:methods* / Q000639:trends; D020360:Neoadjuvant Therapy / Q000379:methods / Q000639:trends; D014411:Neoplastic Stem Cells / Q000637:transplantation; D011788:Quality of Life; D015398:Signal Transduction / Q000235:genetics; D019098:Telomerase / Q000235:genetics / Q000378:metabolism; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D014408:Biomarkers, Tumor; D019098:Telomerase
cancer stem cells; chemoradioresistance; esophageal adenocarcinoma; genetic and epigenetic targets; immunotherapy