Gastrointestinal (GI) cancers, encompassing esophageal, gastric, small bowel, and colorectal carcinomas, represent a significant global health burden due to their high incidence and mortality rates. This review by M. Jesús Fernández-Aceñero et al.
provides an in-depth analysis of the molecular characteristics, prognosis, and current therapeutic strategies for these malignancies, highlighting the latest advancements and challenges in the field. Esophageal carcinoma is among the ten most prevalent tumors globally, with squamous cell carcinoma (SCC) being the most common subtype. Despite geographical variations, SCC accounts for approximately 85% of esophageal cancer cases.
Adenocarcinoma, particularly arising in Barrett's esophagus, is on the rise in Western countries. Early-stage esophageal cancer is primarily treated with surgery, while advanced SCC relies on cytotoxic therapies. Neoadjuvant treatments are commonly employed to facilitate surgical resection.
Despite these interventions, the prognosis remains poor, with less than 15% of patients achieving disease-free status at a five-year follow-up. Recent genomic studies have provided valuable insights into the genetic alterations driving esophageal SCC. Technologies like whole-genome and whole-exome sequencing have identified potential therapeutic targets, such as the WNT/Notch1 pathway and the CCL2-CCR2 axis.
However, targeted therapies, including EGFR inhibitors, have yet to demonstrate clinical efficacy in phase 3 t.
