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Emerging Roles of Phytochemicals in the Pathobiology and Management of Esophageal Cancer

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Phytochemicals Targeting Tumor Microenvironment in Gastrointestinal Cancers

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Abstract

Esophageal cancer demonstrates varying epidemiology across the globe. Over the last 30 years, esophageal adenocarcinoma has overtaken esophageal squamous cell cancer as the most common histologic variety in the Western hemisphere. However, esophageal squamous cell cancer remains the predominant type in Asia. Despite an increase in our understanding of its pathophysiology, varying chemotherapeutic regimens have not made any significant impact on the survival of patients with this disease. These chemotherapeutic agents have potentially severe adverse effects which affect the patient adherence to the given treatment. As an alternative modality of the disease treatment, various phytochemicals have been studied as therapeutic and prophylactic entities for esophageal cancer. Most of these agents exert their effect using antioxidant and anti-inflammatory pathways. In this chapter, we discuss the roles of curcumin, flavonoids, and other agents in terms of the available data. As we move towards preventative care among the high-risk patients with conditions such as Barrett’s esophagus, supplementation of these phytochemicals may lead to halting and decrease in the progression towards malignancy. More robust studies are needed prior to recommending their widespread application; however, in the era of cost-effective medicine, introducing such options in the care of patients will have a significant impact in the long run. We also briefly discuss the current state of chemotherapeutic and immune therapeutic options for patients with esophageal cancer.

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Abbreviations

BSC:

Best supportive care

CD:

Cluster differentiation

COX:

Cyclooxygenase

CSC:

Cancer stem cells

CTLA-4:

Cytotoxic T-lymphocyte-associated protein 4

EAC:

Esophageal adenocarcinoma

EGCG:

Epigallocatechin gallate

EGFR:

Epidermal growth factor receptor

ESC:

Esophageal squamous cell cancer

FDA:

Food and Drug Administration (USA)

FGFR:

Fibroblast growth factor receptor

5-FU:

5-Fluorouracil

GEJ:

Gastroesophageal junctional carcinoma

GERD:

Gastroesophageal reflux disease

HER2:

Human epidermal growth factor receptor 2

IL:

Interleukin

NF-kB:

Nuclear factor-kB

OR:

Odds ratio

ORR:

Objective response rate

OS:

Overall survival

PD-1:

Programmed cell death protein 1

PDGFR:

Platelet-derived growth factor receptor

PD-L1:

Programmed death-ligand 1

PFS:

Progression-free survival

PGE-2:

Prostaglandin E-2

ROS:

Reactive oxygen species

RTK:

Receptor tyrosine kinase

TKI:

Tyrosine kinase inhibitors

VEGFR:

Vascular endothelial growth factor receptor

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Acknowledgements

Author Contributions: Dr. Asad ur Rahman conceived the idea and subsequently all the authors have diligently contributed to the development and preparation of this research work (book chapter), including the literature search, concept organization, data interpretation, and writings. All the authors have read and approved the final draft for publication.

Conflict of Interest: The authors declare that they have no conflicts of interest associated with this book chapter.

Financial Disclosures: None to disclose.

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Authors and Affiliations

  1. Department of Gastroenterology, Cleveland Clinic Florida, Weston, FL, USA

    Asad ur Rahman

  2. Department of Internal Medicine, Advent Health, Orlando, FL, USA

    Deepika Sarvepalli & Mamoon Ur Rashid

  3. Department of Internal Medicine, University of Iowa, Iowa City, IA, USA

    Saeed Ali

  4. Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan

    Awais Naeem

  5. Department of Gastroenterology, Rehman Medical Institute, Peshawar, Pakistan

    Asif Imran

  6. Services Institute of Medical Sciences, Lahore, Pakistan

    Effa Zahid

  7. AdventHealth Cancer Institute, FSU and UCF Colleges of Medicine, Orlando, FL, USA

    Sarfraz Ahmad

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  1. Asad ur Rahman
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Correspondence to Asad ur Rahman or Sarfraz Ahmad .

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Editors and Affiliations

  1. Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, USA

    Ganji Purnachandra Nagaraju

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Rahman, A.u. et al. (2020). Emerging Roles of Phytochemicals in the Pathobiology and Management of Esophageal Cancer. In: Nagaraju, G.P. (eds) Phytochemicals Targeting Tumor Microenvironment in Gastrointestinal Cancers. Springer, Cham. https://doi.org/10.1007/978-3-030-48405-7_8

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