Current status and future of chemotherapy and biochemotherapy in gastroesophageal cancers.

摘要: A number of advances recently have been made in the chemotherapeutic treatment gastroesophageal cancer. Perioperative combination chemotherapy based on cisplatin and 5-fluorouracil (5-FU) improves prognosis patients with stage II III disease. Preoperative initiation seems to be essential for achieving this result, according studies performed West. On other hand, Japanese investigators demonstrated that postoperative administration oral fluoropyrimidine prodrugs can substantially improve curatively resected gastric The addition docetaxel 5-FU has significantly improved response rate, time progression, overall survival treated advanced cancer, as well prolonging definitive worsening global health status Karnofsky performance status. Due increased hematologic toxicity regimen, particularly neutropenic infections, careful patient selection optimal supportive care, including prophylactic granulocyte colonystimulating factor, are required. Alternative schedules being investigated could tolerability plus platinum/fluoropyrimidine regimens. Further improvements outcome may achieved when even more active combinations systematically implemented into preoperative locally cancers. Initial results biologic targeted agents setting promising. Pathways currently under investigation include epidermal growth factor receptors Her-1 Her-2, vascular endothelial epithelial cell adhesion molecule EpCAM. It is hoped targeting these pathways will further increase efficacy biochemotherapy Evaluating early using metabolic imaging a novel approach allow tailoring systemic therapy individual tumor biology. deeper understanding relevant pathognomonic molecular patterns signatures tumors facilitate faster drug development permit accurate therapies future.