Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA.
Department of Radiation Oncology, The Ohio State University, Columbus, OH, USA.
J Natl Cancer Inst. 2021 Jun 1;113(6):665-679. doi: 10.1093/jnci/djaa195.
Although the development of effective combined chemoradiation regimens for esophageal cancers has resulted in statistically significant survival benefits, the majority of patients treated with curative intent develop locoregional and/or distant relapse. Further improvements in disease control and survival will require the development of individualized therapy based on the knowledge of host and tumor genomics and potentially harnessing the host immune system. Although there are a number of gene targets that are amplified and proteins that are overexpressed in esophageal cancers, attempts to target several of these have not proven successful in unselected patients. Herein, we review our current state of knowledge regarding the molecular pathways implicated in esophageal carcinoma, and the available agents for targeting these pathways that may rationally be combined with standard chemoradiation, with the hope that this commentary will guide future efforts of novel combinations of therapy.
虽然有效的联合放化疗方案的发展已经导致了统计学上显著的生存获益，但大多数接受根治性治疗的患者会出现局部区域和/或远处复发。进一步提高疾病控制和生存需要基于宿主和肿瘤基因组学知识制定个体化治疗，并可能利用宿主免疫系统。尽管食管癌中有许多基因靶点被扩增，许多蛋白质过表达，但在未选择的患者中，针对其中一些靶点的尝试并未取得成功。在此，我们回顾了目前关于食管癌中涉及的分子途径的知识状态，以及可用于靶向这些途径的现有药物，这些药物可能与标准放化疗合理联合，希望本评论能够指导未来新型治疗联合的努力。
