Development of new drug strategies in infrequent digestive tumors: esophageal, biliary tract, and anal cancers

Curr Opin Oncol. 2009 Jul;21(4):374-80. doi: 10.1097/CCO.0b013e32832c9464.

Abstract

Purpose of review: In the last years, interesting advances have been reported in the treatment of infrequent digestive tumors. The increasing development of new targeted therapies in human cancer has also impacted in these rare gastrointestinal malignancies providing a wide range of possibilities in the design of future clinical trials.

Recent findings: The inhibition of angiogenesis and the blockage of the epidermal growth factor receptor pathway have provided the most interesting activity in recently reported studies for esophageal and biliary tract carcinomas. Additionally, several targeted therapies have been developed to target the main kinase proteins of the most important pathways of these malignancies. The results of the biggest phase III trial in locally advanced anal carcinoma have been recently published. Finally, the inhibition of epidermal growth factor receptor has also showed promising activity in anal carcinomas.

Summary: Recent advances in the knowledge of molecular mechanism of carcinogenesis have led to meaningful changes in the management of gastrointestinal cancers. Although the major advances in targeted therapy have been introduced in the treatment of colorectal cancer, new interesting approaches have been reported in less frequent gastrointestinal tumors such as esophageal, biliary tract, and anal canal carcinoma opening a new hope in the treatment of these rare tumors in the molecular targeted therapy era.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Anus Neoplasms / blood supply
  • Anus Neoplasms / drug therapy
  • Anus Neoplasms / enzymology
  • Biliary Tract Neoplasms / blood supply
  • Biliary Tract Neoplasms / drug therapy
  • Biliary Tract Neoplasms / enzymology
  • Digestive System Neoplasms / blood supply
  • Digestive System Neoplasms / drug therapy*
  • Digestive System Neoplasms / enzymology
  • Drug Delivery Systems
  • ErbB Receptors / antagonists & inhibitors
  • Esophageal Neoplasms / blood supply
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / enzymology
  • Humans
  • Neovascularization, Pathologic / drug therapy

Substances

  • Angiogenesis Inhibitors
  • ErbB Receptors