The Management of Esophagogastric Cancers Enters a New Era

This timely issue of Hematology/Oncology Clinics of North America highlights the current management of cancers of the foregut (esophagus and stomach). Cancers of the esophagus and stomach remain prevalent, and together, are more common globally than cancers of the colon and rectum or hepatocellular cancer. Importantly, these cancers still carry a poor prognosis and remain a fruitful area for research and drug development. I am very proud of this issue and in particular of my friends and colleagues who were able to contribute scholarly articles that help define the disease and our care. In this issue, we highlight the current understanding of disease biology and epidemiology, including the potential impact of the microbiome on carcinogenesis. We also address current concepts in cancer staging and management of localized disease. For more advanced disease, it is important to understand that we have witnessed an explosion of novel treatments for solid tumor malignancies, including therapies that augment the immune response to tumors. In cancers of the esophagus and stomach, we have been able to add novel targeted agents to our armamentarium of cytotoxic therapies, including agents that target angiogenesis and the epidermal growth factor pathway. However, most impressive is that there are currently thousands of patients with foregut malignancies that are enrolled in clinical trials examining novel treatment strategies and novel therapeutics. This explosion of activity will be accompanied by many new treatment options for our patients moving forward. Herein, we provide a context of standard treatment options as well as novel therapies that appear promising. Although, unfortunately, most patients with cancers of the esophagus and stomach will ultimately die of their disease, there is tremendous hope that we are in the dawn of a new era in the management of these diseases: where understanding the biology and carcinogenesis of the disease will lead to smarter ways to prevent or screen for the disease, where management of localized disease will have more specific and targeted algorithms, and where new treatments will be identified that can dramatically improve upon or augment the outcomes we observe with chemotherapy alone. I enjoin you to continue reading and contribute to this transformation that I see coming for patients with gastric and esophageal cancer.

Only gold members can continue reading. Log In or Register to continue