Toward Precision Perioperative Therapy in GI Malignancies.

Area of Science:

• Gastroenterology
• Oncology
• Genomics

Background:

• Precision oncology guides cancer therapies using molecular data.
• Precision perioperative therapy focuses on molecularly identifying patients likely to benefit from perioperative drugs for resectable cancers.
• This approach is increasingly used for localized gastrointestinal (GI) cancers.

Purpose of the Study:

• To summarize the current status of precision perioperative therapy for GI cancers.
• To highlight areas for future innovation in this field.

Main Methods:

• Literature review of PubMed articles (2017-2023) using terms like "adjuvant," "perioperative," "neoadjuvant," and "precision medicine" for GI malignancies.
• Inclusion of data from ongoing clinical trials accessed via ClinicalTrials.gov (January 2023).

Main Results:

• Emerging paradigms include minimal residual disease detection using circulating tumor DNA.
• Perioperative immunotherapy shows promise for mismatch repair-deficient disease, potentially reducing toxicity.
• Molecularly targeted drugs active in metastatic settings may benefit curable GI cancers.

Conclusions:

• Precision perioperative therapy for GI cancers is an evolving field with early promising data.
• Ongoing research is expected to advance the application of precision perioperative therapy for patients with resectable GI malignancies.