Epidermal growth factor receptor (EGFR)-targeted therapies in esophagogastric cancer

Esophageal and gastric cancer incidence has been increasing worldwide. Most cases are diagnosed in advanced stages, and current therapy has not been able to improve the modest survival rates after diagnosis. Epidermal growth factor receptor expression has been found to correlate with poor prognosis and aggressive disease in esophagogastric cancers. Targeting these receptors through monoclonal antibody or downstream inhibition of tyrosine kinase has produced some encouraging results. The Trastuzumab for Gastric Cancer (ToGA) trial demonstrated that trastuzumab, a monoclonal antibody directed against the Her-2 receptor improves survival in Her-2 positive advanced gastric and gastro-esophageal cancers. Encouraging results have been reported in the ongoing clinical trials of EGFR-directed therapies in combination with concurrent chemoradiation for the locally advanced esophagogastric cancers. Identification of pertinent biomarkers of efficacy will likely lead to further optimization of EGFR-directed treatment. In the current article, we will be discussing the mechanisms of action, completed phase II/III trials and future of epidermal growth factor targeted-therapy in gastric and esophageal cancers.