Publications

Authors:

Pasini, Felice; Fraccon, Anna Paola; Modena, Yasmina; Bencivenga, Maria; Giacopuzzi, Simone; LA RUSSA, Francesca; Gusella, Milena; DE MANZONI, Giovanni

Title:

Targeted therapies for advanced and metastatic adenocarcinoma of the gastroesophageal junction: is there something new?

Year:

2017

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

Sì

Name of journal:

Gastric Cancer

ISSN of journal:

1436-3291

N° Volume:

20

Number or Folder:

1

Page numbers:

31-42

Keyword:

Advanced disease; Gastroesophageal junction adenocarcinoma; Targeted therapies

Short description of contents:

Despite improvements in systemic chemotherapy (CT), the prognosis of metastatic adenocarcinoma of the gastroesophageal junction remains poor. Over the years, new targeting agents have become available and were tested, with or without CT, in first or subsequent lines of therapy. The epidermal growth factor receptor family was targeted with monoclonal antibodies (MoAbs) (trastuzumab, cetuximab, panitumumab) and tyrosin kinase inhibitors (TKIs) (lapatinib, erlotinib, gefitinib). Only trastuzumab, in combination with cisplatin and fluoropyrimidines, significantly improved overall survival (OS) in first-line therapy (13.8 vs. 11.1 months). Angiogenesis also was targeted with MoAbs (bevacizumab and ramucirumab); ramucirumab, a vascular endothelial growth factor-receptor 2 antagonist, enhanced OS in two phase III studies in the first (9.6 vs. 7.4 months) and subsequent lines of treatment (5.2 vs. 3.8 months), while the bevacizumab study was negative. TKIs (sunitinib, sorafenib, regorafenib, apatinib) were tested in this setting in phase II studies in the second/third line, only showing modest antitumor activity. The hepatocyte growth factor receptor (MET) was targeted in untreated patients in a phase III trial with MoAb rilotumumab, with or without CT, but the study was stopped because of mortality excess in the rilotumumab arm. Mammalian target of rapamycin (MTOR) pathway inhibition with everolimus was tested in pretreated patients in a placebo-controlled phase III trial who failed to improve OS (5.4 vs. 4.3 months). In conclusion, considering the modest survival gain obtained overall, the high cost of these therapies and the quality of life issue must be primarily considered in treating these patients.

Product ID:

95138

Handle IRIS:

11562/955217

Last Modified:

November 15, 2022

Bibliographic citation:

Pasini, Felice; Fraccon, Anna Paola; Modena, Yasmina; Bencivenga, Maria; Giacopuzzi, Simone; LA RUSSA, Francesca; Gusella, Milena; DE MANZONI, Giovanni, Targeted therapies for advanced and metastatic adenocarcinoma of the gastroesophageal junction: is there something new? «Gastric Cancer» , vol. 20 , n. 1 , 2017 , pp. 31-42

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo