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Neoadjuvant and adjuvant approaches in gastroesophageal cancers

Magdalena K Scheck1, Michael Masetti, Sylvie Lorenzen

  • 1III. Medizinische Klinik and Poliklinik, TUM School of Medicine, Technical University of Munich, Munich, Germany.

Current Opinion in Oncology
|May 24, 2023
PubMed
Abstract

Insights

Advances in perioperative treatment for gastroesophageal cancer are improving outcomes. Biomarker-based targeted therapies and immune checkpoint inhibitors offer new hope for better survival rates.

Area of Science:

  • Oncology
  • Gastroenterology
  • Immunotherapy

Background:

  • Prognosis for locally advanced gastroesophageal cancer remains poor despite current perioperative treatments.
  • Evolving chemoradiotherapy and chemotherapy regimens have shown limited success in improving outcomes.

Approach:

  • This review examines current and investigational perioperative treatment strategies for curatively intended gastroesophageal cancer.
  • Focus is placed on biomarker-based approaches, including targeted therapies and immune checkpoint inhibition.

Key Points:

  • Immune checkpoint inhibition has demonstrated positive effects on survival in advanced esophageal cancer post-chemoradiotherapy (e.g., CheckMate577).
  • Ongoing studies are integrating immunotherapy and targeted therapy into neoadjuvant and adjuvant settings.
  • Biomarker-driven strategies hold significant promise for enhancing treatment efficacy.

Conclusions:

  • Despite progress, there is a continued need to improve response rates and overall survival in gastroesophageal cancer.
  • Future research directions involve optimizing standard care with novel immunotherapeutic and targeted agents.
  • Personalized medicine approaches utilizing biomarkers are crucial for advancing gastroesophageal cancer treatment.

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