Management of early-stage gastro-esophageal cancers: expert perspectives from the Australasian Gastrointestinal Trials Group (AGITG) with invited international faculty.

2020-04-20

Roy, Amitesh C

Shapiro, Jeremy

Burge, Matt

Karapetis, Christos S

Pavlakis, Nick

Segelov, Eva

Chau, Ian

Lordick, Florian

Chen, Li-Tong

Barbour, Andrew

Tebbutt, Niall C

Price, Tim

Gastric

adjuvant

chemotherapy

oesophageal

peri operative

Journal Article

0000-0002-3922-2693

10.1080/14737140.2020.1746185

Introduction: A multimodal approach in operable early-stage oesophago-gastric (OG) cancer has evolved in the last decade, leading to improvement in overall outcomes.Areas covered: A review of the published literature and conference abstracts was undertaken on the topic of optimal adjunctive chemotherapy or chemoradiotherapy in early-stage OG cancers. This review article focuses on the current evidence pertaining to neoadjuvant and perioperative strategies in curable OG cancers including the evolving landscape of immunotherapy and targeted drugs in this setting.Expert commentary: Adjunctive therapies in the form of preoperative chemo-radiotherapy (CRT) or chemotherapy and perioperative chemotherapy over surgery alone improve outcomes in patients with operable OG cancer. Although there are variations in practice around the world, a multi-disciplinary approach to patient care is of paramount importance. Immunotherapy and on treatment functional imaging are two examples of emerging strategies to improve the outcome for early-stage patients. A better understanding of the molecular biology of this disease may help overcome the problem of tumor heterogeneity and enable more rationally designed and targeted therapeutic interventions in the future.

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Expert Review of Anticancer Therapy 2020; 20(4): 305-324

Expert Review of Anticancer Therapy