Skip to main content
SpringerLink
Log in

Unresectable and Metastatic Cancer

  • Chapter
  • First Online:
Adenocarcinoma of the Esophagogastric Junction

  • 918 Accesses

Abstract

In the past decades, survival improvement was overall modest with conventional chemotherapy regimens, and 2-year survival rate did not exceed the 20 %.

Presently, phase III randomized trials devoted to adenocarcinoma of the esophagogastric junction are lacking, and historically these patients have been enrolled in gastric cancer trials; however, these studies were not statistically powered to examine separately the two entities.

Due to the disappointing results, innovative approaches have been experimented using new drugs such as the novel targeting agents. So far, phase II and III clinical trials tested strategies targeting the epidermal growth factor family, angiogenesis, MET, mTOR, by means of monoclonal antibodies or small molecules inhibiting tyrosine kinase receptor. Nevertheless, metastatic adenocarcinoma of the esophagogastric junction remains an incurable disease, and treatment options should primarily take into account the quality of life of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.00
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Wiedmann MW, Mössner J (2013) New and emerging combination therapies for esophageal cancer. Cancer Manag Res 5:133–146

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Pasini F, Fraccon AP, de Manzoni G (2011) The role of chemotherapy in metastatic gastric cancer. Anticancer Res 31(10):3543–3554

    CAS  PubMed  Google Scholar 

  3. Hofheinz RD, Al-Batran SE, Ridwelski K et al (2010) Population-based patterns of care in the first-line treatment of patients with advanced esophagogastric adenocarcinoma in Germany. Onkologie 33(10):512–518

    Article  PubMed  Google Scholar 

  4. Wang KL, Wu TT, Choi IS et al (2007) Expression of epidermal growth factor receptor in esophageal and esophagogastric junction adenocarcinomas: association with poor outcome. Cancer 109(4):658–667

    Article  CAS  PubMed  Google Scholar 

  5. Pinto C, Di Fabio F, Barone C et al (2009) Phase II study of cetuximab in combination with cisplatin and docetaxel in patients with untreated advanced gastric or gastro-oesophageal junction adenocarcinoma (DOCETUX study). Br J Cancer 101:1261–1268

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Lordick F, Luber B, Lorenzen S et al (2010) Cetuximab plus oxaliplatin/leucovorin/5-fluorouracil in first-line metastatic gastric cancer: a phase II study of the Arbeitsgemeinschaft Internistische Onkologie (AIO). Br J Cancer 102:500–505

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Moehler M, Mueller A, Trarbach T et al (2011) Cetuximab with irinotecan, folinic acid and 5-fluorouracil as first-line treatment in advanced gastroesophageal cancer: a prospective multi-center biomarker-oriented phase II study. Ann Oncol 22:1358–1366

    Article  CAS  PubMed  Google Scholar 

  8. Rao S, Starling N, Cunningham D et al (2010) Matuzumab plus epirubicin, cisplatin and capecitabine (ECX) compared with epirubicin, cisplatin and capecitabine alone as first-line treatment in patients with advanced oesophago-gastric cancer: a randomised, multicentre open-label phase II study. Ann Oncol 21:2213–2219

    Article  CAS  PubMed  Google Scholar 

  9. Gold PJ, Goldman B, Iqbal S et al (2010) Cetuximab as second-line therapy in patients with metastatic esophageal adenocarcinoma: a phase II Southwest Oncology Group Study (S0415). J Thorac Oncol 5(9):1472–1476

    Article  PubMed  PubMed Central  Google Scholar 

  10. Trarbach T, Przyborek M, Schleucher N et al (2013) Phase I study of matuzumab in combination with 5-fluorouracil, leucovorin and cisplatin (PLF) in patients with advanced gastric and esophagogastric adenocarcinomas. Invest New Drugs 31:642–652

    Article  CAS  PubMed  Google Scholar 

  11. Okines AF, Ashley SE, Cunningham D et al (2010) Epirubicin, oxaliplatin, and capecitabine with or without panitumumab for advanced esophagogastric cancer: dose-finding study for the prospective multicenter, randomized, phase II/III REAL-3 trial. J Clin Oncol 28(25):3945–3950

    Article  CAS  PubMed  Google Scholar 

  12. Waddell T, Chau I, Cunningham D et al (2013) Epirubicin, oxaliplatin, and capecitabine with or without panitumumab for patients with previously untreated advanced oesophagogastric cancer (REAL3): a randomised, open-label phase 3 trial. Lancet Oncol 14:481–489

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Lordick F, Kang YK, Chung HC et al (2013) Capecitabine and cisplatin with or without cetuximab for patients with previously untreated advanced gastric cancer (EXPAND): a randomised, open-label phase 3 trial. Lancet Oncol 14:490–499

    Article  CAS  PubMed  Google Scholar 

  14. Bang YJ, Van Cutsem E, Feyereislova A et al (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomized controlled trial. Lancet 376:687–697

    Article  CAS  PubMed  Google Scholar 

  15. Hecht JR, Bang YJ, Qin S et al (2013) Lapatinib in combination with capecitabine plus oxaliplatin (CapeOx) in HER2-positive advanced or metastatic gastric, esophageal, or gastroesophageal adenocarcinoma (AC): the TRIO-013/LOGiC Trial. J Clin Oncol 31(Suppl LBA 4001)

    Google Scholar 

  16. Ferry DR, Anderson M, Beddard K et al (2007) A phase II study of gefitinib monotherapy in advanced esophageal adenocarcinoma: evidence of gene expression, cellular, and clinical response. Clin Cancer Res 13:5869–5875

    Article  CAS  PubMed  Google Scholar 

  17. Adelstein DJ, Rodriguez CP, Rybicki LA et al (2012) A phase II trial of gefitinib for recurrent or metastatic cancer of the esophagus or gastroesophageal junction. Invest New Drugs 30(4):1684–1689

    Article  CAS  PubMed  Google Scholar 

  18. Wainberg ZA, Lin LS, Di Carlo B et al (2011) Phase II trial of modified FOLFOX6 and erlotinib in patients with metastatic or advanced adenocarcinoma of the oesophagus and gastro-oesophageal junction. Br J Cancer 105(6):760–765

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Dragovich T, McCoy S, Fenoglio-Preiser CM et al (2006) Phase II trial of erlotinib in gastroesophageal junction and gastric adenocarcinomas: SWOG 0127. J Clin Oncol 24(30):4922–4927

    Article  CAS  PubMed  Google Scholar 

  20. Ilson DH, Kelsen D, Shah M et al (2011) A phase 2 trial of erlotinib in patients with previously treated squamous cell and adenocarcinoma of the esophagus. Cancer 117(7):1409–1414

    Article  CAS  PubMed  Google Scholar 

  21. Ohtsu A, Shah MA, Van Cutsem E et al (2011) Bevacizumab in combination with chemotherapy as first-line therapy in advanced gastric cancer: a randomized, double-blind, placebo-controlled phase III study. J Clin Oncol 29:3968–3976

    Article  CAS  PubMed  Google Scholar 

  22. Fuchs CS, Tomasek J, Yong CJ et al (2014) Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet 383(9911):31–39

    Article  CAS  PubMed  Google Scholar 

  23. Wilke H, Van Cutsem E, Oh SC et al (2014) RAINBOW: a global, phase III, randomized, double-blind study of ramucirumab plus paclitaxel versus placebo plus paclitaxel in the treatment of metastatic gastroesophageal junction (GEJ) and gastric adenocarcinoma following disease progression on first-line platinum- and fluoropyrimidine-containing combination therapy rainbow IMCL CP12-0922 (I4T-IEJVBE). J Clin Oncol 32(Suppl 3 abstr LBA7)

    Google Scholar 

  24. Martin-Richard M, Gallego R, Pericay C et al (2013) Multicenter phase II study of oxaliplatin and sorafenib in advanced gastric adenocarcinoma after failure of cisplatin and fluoropyrimidine treatment. A GEMCAD study. Invest New Drugs 31:1573–1579

    Article  CAS  PubMed  Google Scholar 

  25. Sun W, Powell M, O’Dwyer PJ et al (2010) Phase II study of sorafenib in combination with docetaxel and cisplatin in the treatment of metastatic or advanced gastric and gastroesophageal junction adenocarcinoma: ECOG 5203. J Clin Oncol 28:2947–2951

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Moehler MH, Thuss-Patience PC, Schmoll HJ et al (2013) FOLFIRI plus sunitinib versus FOLFIRI alone in advanced chemorefractory esophagogastric cancer patients: a randomized placebo-controlled multicentric AIO phase II trial. J Clin Oncol 31(Suppl abstr 4086)

    Google Scholar 

  27. Bang YJ, Kang YK, Kang WK et al (2011) Phase II study of sunitinib as second-line treatment for advanced gastric cancer. Invest New Drugs 29:1449–1458

    Article  CAS  PubMed  Google Scholar 

  28. Moehler M, Mueller A, Hartmann JT et al (2011) An open-label, multicentre biomarker-oriented AIO phase II trial of sunitinib for patients with chemo-refractory advanced gastric cancer. Eur J Cancer 47:1511–1520

    Article  CAS  PubMed  Google Scholar 

  29. Morishita A, Gong J, Masaki T (2014) Targeting receptor tyrosine kinases in gastric cancer. World J Gastroenterol 20(16):4536–4545

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Oliner KS, Tang R, Anderson A et al (2012) Evaluation of MET pathway biomarkers in a phase II study of rilotumumab (R, AMG 102) or placebo (P) in combination with epirubicin, cisplatin, and capecitabine (ECX) in patients (pts) with locally advanced or metastatic gastric (G) or esophagogastric junction (EGJ) cancer. J Clin Oncol 30(Suppl abstr 4005)

    Google Scholar 

  31. Doi T, Muro K, Boku N et al (2010) Multicenter phase II study of everolimus in patients with previously treated metastatic gastric cancer. J Clin Oncol 28(11):1904–1910

    Article  CAS  PubMed  Google Scholar 

  32. Ohtsu A, Ajani JA, Bai YX et al (2013) Everolimus for previously treated advanced gastric cancer: results of the randomized, double-blind, phase III GRANITE-1 study. J Clin Oncol 31(31):3935–3943

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Unità Operativa Complessa di Oncologia, Ospedale S. Maria della Misericordia, Rovigo, Italy

    Felice Pasini & Yasmina Modena

  2. Servizio di Oncologia, Casa di Cura Pederzoli, Peschiera del Garda (Verona), Italy

    Anna Paola Fraccon

Authors
  1. Felice Pasini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anna Paola Fraccon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasmina Modena
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Felice Pasini .

Editor information

Editors and Affiliations

  1. Upper Gastrointestinal and General Surgery, University of Verona, Verona, Italy

    Simone Giacopuzzi

  2. Upper Gastrointestinal and General Surgery, University of Verona, Verona, Italy

    Andrea Zanoni

  3. Upper Gastrointestinal and General Surgery, University of Verona, Verona, Italy

    Giovanni de Manzoni

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Pasini, F., Fraccon, A.P., Modena, Y. (2017). Unresectable and Metastatic Cancer. In: Giacopuzzi, S., Zanoni, A., de Manzoni, G. (eds) Adenocarcinoma of the Esophagogastric Junction. Springer, Cham. https://doi.org/10.1007/978-3-319-28776-8_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-28776-8_22

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28774-4

  • Online ISBN: 978-3-319-28776-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation