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Esophagogastric cancer: integration of targeted therapies into systemic chemotherapy

M Moehler1, S Schwarz, A D Wagner

  • 1Johannes Gutenberg University of Mainz, First Department of Internal Medicine, Langenbeckstrasse 1, 55116 Mainz, Germany. moehler@mail.uni-mainz.de

Current Cancer Drug Targets
|June 10, 2011
PubMed

Insights

Targeted therapies show promise for advanced esophagogastric cancer. Trastuzumab improves survival in HER2-positive patients, establishing a new standard of care.

Area of Science:

  • Oncology
  • Gastroenterology
  • Pharmacology

Background:

  • Advanced esophagogastric cancer treatment remains challenging, with limited survival benefits from current combination chemotherapy.
  • Targeted therapies are emerging but lag behind integration in clinical practice compared to other GI diseases.

Purpose of the Study:

  • To review recent advancements in targeted therapies for advanced esophagogastric cancer.
  • To evaluate the efficacy of agents targeting angiogenesis and epidermal growth factor receptors (EGFR1, HER2).

Main Methods:

  • Review of recent phase III trial results for targeted agents, including trastuzumab and bevacizumab.
  • Analysis of combination chemotherapy regimens with targeted therapies in advanced esophagogastric cancer.

Main Results:

  • Trastuzumab, when added to cisplatin/5-fluoropyrimidine chemotherapy, significantly improves survival in HER2-positive patients.
  • Bevacizumab addition to chemotherapy did not yield a significant survival benefit.
  • HER2 testing is recommended for all metastatic esophagogastric cancer patients.

Conclusions:

  • Trastuzumab combined with chemotherapy is the new standard of care for HER2-positive advanced gastric cancer.
  • Targeted therapy, particularly HER2-directed treatment, offers a clinically relevant survival benefit in a subset of patients.

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