Diagnosis and Treatment of Upper Gastrointestinal Malignancies: Current Advances and Future Prospects

A special issue of Diseases (ISSN 2079-9721). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 10382

Special Issue Editor

Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
Interests: prostate cancer; kidney cancer; bladder cancer; disparities; tumor metabolism; clinical trials
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cancers of the upper gastrointestinal tract constitute a high global burden, with gastric and esophageal cancers representing the fifth and sixth most common cancers worldwide, respectively. Cancers of the esophagus, stomach, and small bowel comprise a heteregenous group of malignancies distinguished by differences in histopathologic classification, risk factors and etiologies, and incidence and epidemiologic patterns, and, more recently, with comprehensive molecular profiling and molecular classification, leading to precision-based systemic therapy options in select scenarios. Despite improvements in screening, diagnosis, and radiation, surgical, and systemic therapies, global survival rates remain unsatisfactory, and the disease remains incurable in advanced stages.

The focus of this Special Issue is to highlight our global research efforts to improve outcomes in patients with upper gastrointestinal cancers. We recognize that dramatic improvements in the management of these malignancies in recent decades have resulted from multidisciplinary evaluation and treatment of patients. As such, we invite colleagues from across all disciplines: epidemiology, basic and translational science, genetics, nutrition, surgery, surgical oncology, hematology and oncology, radiation oncology, radiology, interventional radiology, gastroenterology, interventional gastroenterology, palliative care, and pathology, to highlight recent advancements in their respective fields that have contributed to the global care of patients with upper gastrointestinal cancers.

Dr. Jun Gong
Guest Editor

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Keywords

  • gastric cancer
  • esophageal cancer
  • small bowel cancer
  • gastrointestinal cancer
  • screening
  • diagnosis
  • surgery
  • endoscopic
  • systemic therapy
  • radiation therapy

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Published Papers (3 papers)

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Review

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21 pages, 2713 KiB  
Review
Role of Endoscopy in Management of Upper Gastrointestinal Cancers
by Jeff Liang, Yi Jiang, Yazan Abboud and Srinivas Gaddam
Diseases 2023, 11(1), 3; https://doi.org/10.3390/diseases11010003 - 27 Dec 2022
Cited by 1 | Viewed by 5213
Abstract
Upper gastrointestinal (GI) malignancy is a leading cause of cancer-related morbidity and mortality. Upper endoscopy has an established role in diagnosing and staging upper GI cancers, screening for pre-malignant lesions, and providing palliation in cases of advanced malignancy. New advances in endoscopic techniques [...] Read more.
Upper gastrointestinal (GI) malignancy is a leading cause of cancer-related morbidity and mortality. Upper endoscopy has an established role in diagnosing and staging upper GI cancers, screening for pre-malignant lesions, and providing palliation in cases of advanced malignancy. New advances in endoscopic techniques and technology have improved diagnostic accuracy and increased the therapeutic potential of upper endoscopy. We aim to describe the different types of endoscopic technology used in cancer diagnosis, summarize the current guidelines for endoscopic diagnosis and treatment of malignant and pre-malignant lesions, and explore new potential roles for endoscopy in cancer therapy. Full article
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11 pages, 266 KiB  
Review
Therapeutic Advances and Challenges in the Management of HER2-Positive Gastroesophageal Cancers
by Jeremy Chuang, Samuel Klempner, Kevin Waters, Katelyn Atkins, Joseph Chao, May Cho, Andrew Hendifar, Alexandra Gangi, Miguel Burch, Pareen Mehta and Jun Gong
Diseases 2022, 10(2), 23; https://doi.org/10.3390/diseases10020023 - 19 Apr 2022
Cited by 1 | Viewed by 2545
Abstract
Gastroesophageal cancer is one of the most common cancers in the world, with a high rate of mortality. While there has been significant progress over the past decade, particularly with the addition of anti-HER2 therapies to platinum-based chemotherapy agents in the advanced setting, [...] Read more.
Gastroesophageal cancer is one of the most common cancers in the world, with a high rate of mortality. While there has been significant progress over the past decade, particularly with the addition of anti-HER2 therapies to platinum-based chemotherapy agents in the advanced setting, the prognosis remains poor and the treatment options for this disease entity remain limited. In this review, we discuss the current therapeutic landscape for HER2-positive gastroesphageal cancer and the seminal clinical trials that have shaped our approach to this disease entity. In addition, we highlight some of the challenges to the understanding and management of this disease, specifically discussing the breadth of molecular diversity and intratumoral heterogeneity of HER2 expression that impact the clinical efficacy and prognosis. Furthermore, we discuss the potential role of next-generation sequencing (NGS) and circulating-tumor DNA (ctDNA) as complementary tools to immunohistochemistry (IHC) and fluorescent in-situ hybridization (FISH) to guiding clinical decision making. Finally, we highlight promising clinical trials of new treatment regimens that will likely reshape the therapeutic approach to this disease entity. Full article

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6 pages, 530 KiB  
Brief Report
Early Adoption of Checkpoint Inhibitors in Patients with Metastatic Gastric Adenocarcinoma—A Case Series of Non-Operative Long-Term Survivors
by Dalia Kaakour, Garrett Ward and Farshid Dayyani
Diseases 2022, 10(2), 24; https://doi.org/10.3390/diseases10020024 - 24 Apr 2022
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Abstract
Checkpoint inhibitor (CPI) therapy has only recently been introduced in the first-line treatment of advanced gastric cancer. However, later line monotherapy CPI efficacy in a subset of patients was presented about four years prior. Here, we present three cases of advanced gastric adenocarcinoma [...] Read more.
Checkpoint inhibitor (CPI) therapy has only recently been introduced in the first-line treatment of advanced gastric cancer. However, later line monotherapy CPI efficacy in a subset of patients was presented about four years prior. Here, we present three cases of advanced gastric adenocarcinoma cancers treated with CPI in early lines years prior to the availability of randomized first line data. All three patients remain in remission without gastrectomy, with the median time from initial diagnosis of approximately 52 months. With long-term follow-up of more than four years, we present a proof of concept that, with early integration of CPI therapy, highly durable responses are possible even in the absence of surgery in patients with advanced gastric and gastroesophageal junction cancers. Full article
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