Targeting key signalling pathways in oesophageal adenocarcinoma: a reality for personalised medicine?

World J Gastroenterol. 2011 Jun 21;17(23):2781-90. doi: 10.3748/wjg.v17.i23.2781.

Abstract

Cancer treatments are rapidly changing. Curative treatment for oesophageal adenocarcinoma currently involves surgery and cytotoxic chemotherapy or chemoradiotherapy. Outcomes for both regimes are generally poor as a result of tumor recurrence. We have reviewed the key signalling pathways associated with oesophageal adenocarcinomas and discussed the recent trials of novel agents that attempt to target these pathways. There are many trials underway with the aim of improving survival in oesophageal cancer. Currently, phase 2 and 3 trials are focused on MAP kinase inhibition, either through inhibition of growth factor receptors or signal transducer proteins. In order to avoid tumor resistance, it appears to be clear that targeted therapy will be needed to combat the multiple signalling pathways that are in operation in oesophageal adenocarcinomas. This may be achievable in the future with the advent of gene signatures and a combinatorial approach.

Keywords: MAP and PI3 Kinase pathways; Nuclear factor-κB pathways; Oesophageal adenocarcinoma; Signalling pathways; Transcription factors; Transforming growth factor-β pathway; Tyrosine kinase receptors; Wnt signalling.

Publication types

  • Editorial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / physiopathology*
  • Antibodies, Monoclonal / metabolism
  • Clinical Trials as Topic
  • ErbB Receptors / metabolism
  • Esophageal Neoplasms / physiopathology*
  • Humans
  • Mitogen-Activated Protein Kinases / metabolism
  • NF-kappa B / metabolism
  • Phosphatidylinositol 3-Kinases / metabolism
  • Precision Medicine*
  • Receptors, Vascular Endothelial Growth Factor / metabolism
  • Signal Transduction / physiology*
  • TOR Serine-Threonine Kinases / metabolism
  • Wnt Proteins / metabolism

Substances

  • Antibodies, Monoclonal
  • NF-kappa B
  • Wnt Proteins
  • MTOR protein, human
  • EGFR protein, human
  • ErbB Receptors
  • Receptors, Vascular Endothelial Growth Factor
  • TOR Serine-Threonine Kinases
  • Mitogen-Activated Protein Kinases