Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer

Gastric & Breast Cancer e-journal
DOI: 10.2122/gbc.2011.0151

OPINION

Multimodal treatment including trastuzumab for gastroesophageal junction cancer: Controversy, and individualized decision.

Prof. Andreas Sendler, M.D., Ph.D

Affiliation: Direktor der Chirurgischen Universitätsklinik, Marienhospital Herne Klinikum der Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Germany.

E-mail : Andreas.Sendler@ruhr-uni-bochum.de

ABSTRACT

Cancer arises at the gastroesophageal junction (GEJ), namely distant esophagus (type I), cardia (type II) or proximal stomach (type III) has a poor prognosis. Surgery and chemotherapy for resectable disease are the backbone treatment. However, there is still controversy on extent of surgery, timing (preoperative, postoperative, perioperative) of chemotherapy, cytotoxic drugs regimen, radiotherapy and targeted therapy.

Here I discuss the risks and benefits of extensive surgery including thoracotomy and esophagus resection and total gastrectomy, of neoadjuvant or perioperative (before and after surgery) chemotherapy and indications and limitations of trastuzumab. Moreover, I describe how cancer whole genome sequencing and systems biology approaches may lead to novel biomarkers and drugs development with a true clinical benefit for patients with GEJ cancer.

(Citation: Gastric & Breast Cancer 2011; 10(1): 30-35)

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last update: 8 February 2011