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Therapeutic Advances and Challenges in the Management of HER2-Positive Gastroesophageal Cancers

Jeremy Chuang1, Samuel Klempner2, Kevin Waters3

  • 1Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA.

Diseases (Basel, Switzerland)
|June 1, 2022
PubMed

Insights

Treatment for HER2-positive gastroesophageal cancer has advanced, but outcomes remain poor. This review covers current therapies, challenges like tumor heterogeneity, and future directions including new sequencing methods and clinical trials.

Area of Science:

  • Oncology
  • Gastroenterology
  • Molecular Biology

Background:

  • Gastroesophageal cancer presents a significant global health challenge with high mortality rates.
  • Advances include anti-HER2 therapies combined with platinum chemotherapy for advanced disease, yet prognosis remains limited.
  • Limited treatment options persist despite therapeutic progress.

Purpose of the Study:

  • To review the current therapeutic landscape for HER2-positive gastroesophageal cancer.
  • To discuss seminal clinical trials and challenges in managing this disease.
  • To explore the role of novel diagnostic tools and future treatment strategies.

Main Methods:

  • Literature review of clinical trials and therapeutic strategies for HER2-positive gastroesophageal cancer.
  • Analysis of molecular diversity and HER2 expression heterogeneity.
  • Evaluation of next-generation sequencing (NGS) and circulating-tumor DNA (ctDNA) in clinical decision-making.

Main Results:

  • Current treatment paradigms for HER2-positive gastroesophageal cancer are established but face challenges.
  • Molecular diversity and intratumoral heterogeneity of HER2 expression impact treatment efficacy.
  • Next-generation sequencing (NGS) and circulating-tumor DNA (ctDNA) show potential complementary roles to IHC and FISH.

Conclusions:

  • Despite advances, HER2-positive gastroesophageal cancer management requires further innovation.
  • Addressing molecular heterogeneity is crucial for improving clinical outcomes.
  • Emerging diagnostic tools and novel treatment regimens hold promise for future therapeutic approaches.
Keywords:
HER2circulating tumor DNAgastroesophageal cancernext-generation sequencingtrastuzumab

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