State of the Art in the Treatment of Gastrointestinal Stromal Tumors
Background: Gastrointestinal stromal tumors (GISTs) are the most frequently diagnosed mesenchymal neoplasms of the gastrointestinal tract. Despite their biological and clinical heterogeneity, the majority of these tumors are positive for the receptor tyrosine kinase KIT and are driven by KIT- or platelet-derived growth factor receptor alpha (PDGFRA)-activating mutations. There are still uncertainties regarding their clinical and molecular characterization and the optimal treatment regimens, making it difficult to establish a universal treatment algorithm for these tumors. Summary: From a clinical perspective, the main diff...
Source: Gastrointestinal Tumors - April 21, 2015 Category: Gastroenterology Source Type: research
Colorectal Cancer: Personalized Therapy
Background: Colorectal cancer (CRC) is the second most common type of cancer in the Western world. The treatment of this disease has evolved greatly, particularly for patients with metastatic disease. The advent of combination chemotherapy plus targeted agents has led to more curative resections and improved survival rates in these patients. A deeper understanding of the mechanisms of tumorigenesis has facilitated tumor characterization, prognosis and patient stratification, bringing us one step closer towards personalized medicine. Summary: There are two main pathways of CRC development: (1) chromosomal instability, also ...
Source: Gastrointestinal Tumors - April 14, 2015 Category: Gastroenterology Source Type: research
Epigenetic Biomarkers for the Early Detection of Gastrointestinal Cancer
Background: Gastric cancer and colorectal cancer, the two most frequent cancers within the gastrointestinal tract, account for a large proportion of human malignancies worldwide. The initiation and progression of gastrointestinal cancer (GIC) is controlled by both genetic and epigenetic events. Epigenetic alterations, including changes in DNA methylation, specific histone modifications, chromatin remodeling and noncoding RNA-mediated gene silencing, are potentially reversible and heritable. Summary: In this article, we summarize the current advances in epigenetic biomarkers as potential substrates for GIC detection. The co...
Source: Gastrointestinal Tumors - April 14, 2015 Category: Gastroenterology Source Type: research
Viruses, Other Pathogenic Microorganisms and Esophageal Cancer
Background: Esophageal cancer (EC) is the eighth most prevalent malignant tumor and the sixth leading cause of cancer mortality throughout the world. Despite the technical developments in diagnosis and treatment, the 5-year survival rate is still low. The etiology of EC remains poorly understood; multiple risk factors may be involved and account for the great variation in EC incidence in different geographic regions. Summary: Infection with carcinogenetic pathogens has been proposed as a risk factor for EC. This review explores the recent studies on the association of human papillomavirus (HPV), Epstein-Barr virus (EBV), H...
Source: Gastrointestinal Tumors - April 7, 2015 Category: Gastroenterology Source Type: research
Editorial
Gastrointest Tumors 2015;2:1 (Source: Gastrointestinal Tumors)
Source: Gastrointestinal Tumors - April 3, 2015 Category: Gastroenterology Source Type: research
Hepatocellular Cancer: New Kids on the Block
Background: With over 600,000 newly diagnosed hepatocellular cancer (HCC) patients worldwide every year and ongoing clinical research, it is surprising that many of the new molecular entities have not yet resulted in significant prolongation of progression-free or overall survival. Nevertheless, there are a number of promising agents currently under investigation. Given the unique tumor biology and heterogeneous clinical manifestations of HCC, the application of molecular and cellular markers could also benefit patient selection, disease prognosis and trial design. Summary: This paper provides an overview of the current th...
Source: Gastrointestinal Tumors - March 31, 2015 Category: Gastroenterology Source Type: research
Gastric Cancer: New Drugs - New Strategies
Background: Gastric cancer is the second most common cause of cancer-related deaths worldwide. There are large geographic variations in the incidence of these tumors, with 60% occurring in East Asia. For patients with resectable disease, surgery and perioperative treatment can be effective. For patients with advanced gastric cancer, chemotherapy regimens result in a median survival of 9-11 months. In general, the prognosis for advanced disease is poor and 5-year overall survival rates are around 15%. Combination therapies yield better survival rates, albeit with increased toxicity. Therefore, more effective and less toxic ...
Source: Gastrointestinal Tumors - March 27, 2015 Category: Gastroenterology Source Type: research
Pancreatic Cancer: Progress in Systemic Therapy
Background: Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related deaths in the Western world. Due to lack of specific symptoms and no accessible precursor lesions, primary diagnosis is commonly delayed, resulting in the identification of only 15-20% of patients with potentially curable disease. The major limiting factor is an already locally advanced or metastatic disease at the time of diagnosis. Consequently, systemic therapy forms the backbone of treatment strategy for the majority of patients. Summary: A deeper understanding of the molecular characteristics of pancreatic cancer has led to the id...
Source: Gastrointestinal Tumors - March 27, 2015 Category: Gastroenterology Source Type: research
Hereditary Factors in Esophageal Adenocarcinoma
Background: The vast majority of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) cases are sporadic and caused by somatic mutations. However, over the last decades several families have been identified with clustering of EAC. Here, we review data from the published literature in order to address the current knowledge on familial EAC. Summary: Although familial EAC comprises a relatively small group of patients, it is a clinically relevant category due to the poor prognosis of this type of cancer. Efforts should be made to identify specific genetic risk factors for familial EAC to enable identification of relat...
Source: Gastrointestinal Tumors - November 6, 2014 Category: Gastroenterology Source Type: research
Hepatocellular Carcinoma: Current Concepts in Diagnosis, Staging and Treatment
Background: Hepatocellular carcinoma (HCC) significantly contributes to the global burden of cancer. Liver cancer is the third most frequent cause of cancer-related death, with HCC representing more than 90% of primary liver cancers. During the last decade, much progress has been made with respect to the definition of patient populations at risk who may benefit from surveillance strategies, as well as in the diagnosis and treatment of the disease. Summary: New locoregional and systemic therapies have significantly increased the survival of patients with HCC. A multitude of clinical trials addressing patients with HCC have ...
Source: Gastrointestinal Tumors - November 6, 2014 Category: Gastroenterology Source Type: research
Esophageal Cancer: Current Options for Therapeutic Management
This article discusses the appropriate option of the current different curative treatments in patients with EC, including surgical treatment and adjuvant therapy. Key Message: To maximize survival and quality of life and also decrease postoperative complications, the present recommended therapeutic management of EC should be individualized multidisciplinary team approaches according to patients' staging and physiologic reserve. Practical Implications: The aim of this article is to provide a decision support and also a discussion based on clinical therapeutic strategy in order to characterize the beneficial approach which r...
Source: Gastrointestinal Tumors - November 6, 2014 Category: Gastroenterology Source Type: research
Neoadjuvant Therapy of Gastric Cancer: A Decisive Step Forward
Background: Although its incidence has been steadily decreasing in Western countries, gastric cancer remains a leading cause of cancer deaths worldwide. The detection rate of early-stage cancers is improving; nevertheless, the majority of cases is still diagnosed at later stages with a poor prognosis. Furthermore, the results that can be achieved with surgery have reached a plateau of effectiveness. Summary: Neoadjuvant chemotherapy was successfully introduced first in patients with non-curatively resectable disease. In the last decade, neoadjuvant chemotherapy has also been established in potentially curatively resectable...
Source: Gastrointestinal Tumors - November 6, 2014 Category: Gastroenterology Source Type: research
Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China
Background: Colorectal cancer (CRC) is steadily increasing in China. Colorectal adenoma (CRA) is the most important precancerous disease of CRC. Screening for colorectal tumors can aid early diagnosis. Advances in endoscopic mucosal resection and endoscopic submucosal dissection can aid the early treatment of colorectal tumors. Furthermore, because of high risk of recurrence after removal of adenomas under endoscopy, factors contributing to recurrence, the follow-up mode and the interval established, and the feasibility of application and the time of various chemical preventions should be concerned. However, a relevant con...
Source: Gastrointestinal Tumors - November 6, 2014 Category: Gastroenterology Source Type: research
An Update on Helicobacter pylori as the Cause of Gastric Cancer
Background: Gastric cancer is the second most common cause of cancer deaths worldwide. The vast majority of gastric cancers are inflammation-related cancers caused by infection with Helicobacter pylori. H. pylori-induced oxidative stress damages DNA, resulting in genetic instability. In addition, H. pylori itself can cause DNA damage and epigenetic changes that trigger genetic instability and neoplastic transformation. Summary:H. pylori strain-specific components act in combination with host factors and environmental and dietary factors to greatly enhance the inflammatory response and thus the cancer risk. Variations in se...
Source: Gastrointestinal Tumors - November 6, 2014 Category: Gastroenterology Source Type: research
Colorectal Cancer in Inflammatory Bowel Disease: Epidemiology, Pathogenesis and Surveillance
Background: Inflammatory bowel disease (IBD; including ulcerative colitis and Crohn's disease) is associated with an increased risk for colorectal cancer (CRC). Chronic mucosal inflammation is a key factor in the onset of carcinogenesis in IBD patients. Although most gene alterations that cause sporadic CRCs also occur in patients with IBD-associated CRC, some gene sequences and mutation frequencies differ between sporadic CRCs and IBD-associated CRCs. Summary: This review explores the incidence of CRC in IBD patients, with the goal of identifying the risk and protective factors for CRC in order to facilitate dysplasia man...
Source: Gastrointestinal Tumors - November 6, 2014 Category: Gastroenterology Source Type: research
