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Updated: Jun 1, 2026
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Targeting metastatic upper gastrointestinal adenocarcinomas
Jennifer L Spratlin1, Quincy Chu, Sheryl Koski
1Jennifer L Spratlin, Quincy Chu, Sheryl Koski, Karen King, Karen Mulder, Cross Cancer Institute, University of Alberta, T6G 1Z2, Edmonton, Alberta, Canada.
Abstract:
Upper gastrointestinal (GI) tumors, including adenocarcinoma of the esophagus, stomach, pancreas, and biliary tree, have traditionally been difficult to treat with cytotoxic chemotherapeutic agents. There has been little drug development success in treating these cancers over the last 20 years, perhaps a reflection of a combination of the aggressive biology of these tumors, the void in effective and specific drug development for these varied tumors, and the lack of properly designed, biologically-based clinical trials. Recently, so called "targeted agents" have risen to the forefront in the care of cancer patients and have made strong impacts in many areas of oncology, particularly gastrointestinal stromal tumors (GIST), colon, breast, and lung cancers. Unfortunately, slow progress has been made using such agents in upper GI tumors. However, more recently, trials in some tumor types have demonstrated gains in progression free survival and overall survival. In this review, we discuss the drugs and pathways that have been most successful in the treatment of upper GI tumors and present the relevant data supporting their use for each tumor site. Additionally, we will explore a few novel pathways that may prove effective in the treatment of upper GI malignancies in the near future.
Insights
Targeted therapies show recent promise for difficult-to-treat upper gastrointestinal (GI) cancers like esophageal and stomach tumors. This review covers successful drugs and pathways, offering hope for improved patient survival.
Area of Science:
- Oncology
- Gastroenterology
- Pharmacology
Background:
- Upper gastrointestinal (GI) tumors, including esophageal, stomach, pancreatic, and biliary cancers, have historically shown poor response to traditional chemotherapy.
- Limited drug development success over the past two decades is attributed to aggressive tumor biology, lack of specific agents, and inadequate clinical trial design.
Purpose of the Study:
- To review currently successful targeted drugs and pathways for upper GI malignancies.
- To present supporting clinical data for established treatments.
- To explore emerging novel pathways with potential future efficacy.
Main Methods:
- Review of published literature on targeted therapies and clinical trials for upper GI cancers.
- Analysis of progression-free survival and overall survival data from relevant studies.
- Identification and discussion of key molecular targets and pathways.
Main Results:
- While progress has been slow, recent trials indicate gains in progression-free and overall survival for certain upper GI tumors treated with targeted agents.
- Specific drugs and pathways have demonstrated efficacy in distinct upper GI cancer types.
- Several novel therapeutic avenues are under investigation.
Conclusions:
- Targeted therapy represents a growing area of success in managing upper GI cancers, moving beyond traditional chemotherapy limitations.
- Continued research into novel pathways and biologically-based trials is crucial for advancing treatment outcomes.
- Personalized medicine approaches are increasingly important for optimizing care in these complex malignancies.
