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Antiangiogenic Therapy in Gastroesophageal Cancer

Zhaohui Jin1, Harry H Yoon1

  • 1Department of Medical Oncology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.

Hematology/Oncology Clinics of North America
|May 15, 2017
PubMed

Insights

Antiangiogenesis therapy improves survival in advanced stomach and gastroesophageal junction cancer. However, it has not shown benefits in early-stage or esophageal cancers, with ongoing research exploring combinations with other therapies.

Area of Science:

  • Oncology
  • Gastrointestinal Cancer Research
  • Molecular Targeted Therapy

Background:

  • Antiangiogenesis therapy is a key biologically targeted treatment for advanced gastric and gastroesophageal junction (GEJ) adenocarcinoma.
  • It is one of only two targeted approaches to demonstrate improved overall survival compared to standard care in this patient population.

Purpose of the Study:

  • To review the efficacy of antiangiogenesis therapy in advanced gastric/GEJ adenocarcinoma.
  • To identify patient populations and cancer types where antiangiogenesis therapy has not shown survival benefits.
  • To highlight emerging therapeutic strategies involving antiangiogenesis.

Main Methods:

  • Review of clinical trial data and published literature on antiangiogenesis therapies.
  • Analysis of survival outcomes in patients with advanced, previously treated, chemo-naïve, and resectable esophagogastric cancers.
  • Examination of ongoing clinical investigations combining antiangiogenesis with other targeted treatments.

Main Results:

  • Vascular endothelial growth factor receptor 2 (VEGFR2) targeting has improved overall survival in patients with previously treated advanced gastric/GEJ adenocarcinoma.
  • Antiangiogenesis therapy has not demonstrated an overall survival benefit in chemo-naïve or resectable esophagogastric cancers.
  • Efficacy has not been established for tumors arising from the esophagus.

Conclusions:

  • Antiangiogenesis therapy is an established treatment for advanced gastric/GEJ adenocarcinoma, particularly VEGFR2 inhibition.
  • Further research is needed to establish its role in earlier stages of esophagogastric cancer and esophageal tumors.
  • Combination therapies, including with immune checkpoint inhibitors and anti-HER2 therapy, represent promising future directions.
Keywords:
AngiogenesisCheckpoint inhibitorEsophageal cancerGastric cancerImmunotherapy

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