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Authors: Stefan Kasper Martin Schuler
Publish Date: 2014
Volume: , Issue: , Pages: 179-191
Abstract
Gastroesophageal cancers comprising gastric cancer GC and cancers of the distal esophagus and gastroesophageal junction GEJ are a global health threat In Western populations the incidence of GC is declining which has been attributed to effective strategies of eradicating Helicobacter pylori infection To the contrary GEJ cancers are on the rise with obesity and reflux disease being viewed as major risk factors During the past decade perioperative chemotherapy pre or postoperative radiochemotherapy and in Asian populations adjuvant chemotherapy were shown to improve the outcome of patients with advanced GC and GEJ cancers suited for surgery Less progress has been made in the treatment of metastatic disease The introduction of novel immunotherapeutic agents like the monoclonal antibody trastuzumab in patients with HER2positive disease has marked a turning point Recently several novel pharmacological agents targeting growth factor receptors angiogenic pathways adhesion molecules and mediators of intracellular signal transduction have been clinically explored In addition strategies using socalled immune checkpoint inhibitors to enhance the immunological response against tumor cells which showed promising longlasting responses in different types of cancers are currently tested in several clinical trials in GC and GEJ Antigenspecific active immunotherapies and cellular therapies have been less explored Their future role in clinical management of advanced GC/GEJ remains to be defined Here we summarize the current status and future developments of immunological treatment options in GC and GEJ cancer
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