Advances in therapeutic options for esophageal and esophagogastric junctional adenocarcinoma

Introduction: The shifting location of esophageal cancers from proximal to distal and gastric cancers from distal to proximal has resulted in a marked increase in the incidence of esophageal adenocarcinoma (EAC) which also involves tumors localized at esophagogastric junction (EGJ). The trend of increased incidence of EAC has paralleled the upward trend in rates of obesity, gastroesophageal reflux disease (GERD), and the Barrett’s esophagus (BE). Despite the numerous identified targets, the survival rates of EACs has not changed much. Understanding the molecular biology in depth will help to achieve new and more effective therapeutic options and also may help to identify premalignant lesions before conversion to cancer. Areas covered: In this review, we aimed to describe the advances in the therapeutic options for potentially resectable and unresectable EAC. A literature research was performed using PubMed, American Society of Clinical Oncology, European Society for Medical Oncology, and ClinicalTrials.gov websites. Expert opinion: Adequate resection with adjunctive therapies is the backbone component of resectable EAC. Palliative chemotherapy with best supportive care remains as the standard of care for advanced stage disease. Understanding the molecular biology of EAC and its precursor BE will help to convert phenotypic treatment to the more promising genotypic treatment.