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Targeting esophageal carcinoma: molecular mechanisms and clinical studies
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Journal Article
Targeting esophageal carcinoma: molecular mechanisms and clinical studies
2024
Overview
Esophageal cancer (EC) is identified as a predominant health threat worldwide, with its highest incidence and mortality rates reported in China. The complex molecular mechanisms underlying EC, coupled with the differential incidence of esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) across various regions, highlight the necessity for in‐depth research targeting molecular pathogenesis and innovative treatment strategies. Despite recent progress in targeted therapy and immunotherapy, challenges such as drug resistance and the lack of effective biomarkers for patient selection persist, impeding the optimization of therapeutic outcomes. Our review delves into the molecular pathology of EC, emphasizing genetic and epigenetic alterations, aberrant signaling pathways, tumor microenvironment factors, and the mechanisms of metastasis and immune evasion. We further scrutinize the current landscape of targeted therapies, including the roles of EGFR, HER2, and VEGFR, alongside the transformative impact of ICIs. The discussion extends to evaluating combination therapies, spotlighting the synergy between targeted and immune‐mediated treatments, and introduces the burgeoning domain of antibody–drug conjugates, bispecific antibodies, and multitarget‐directed ligands. This review lies in its holistic synthesis of EC's molecular underpinnings and therapeutic interventions, fused with an outlook on future directions including overcoming resistance mechanisms, biomarker discovery, and the potential of novel drug formulations. Potential strategies and potential targets for treating EC. Current the EC's research focuses on pivotal genes EGFR, HER2, TP53, CDKN2A, and APC, targeting key pathways in cell regulation and signaling. We highlight four novel therapeutic strategies: combined targeted therapy with chemotherapy, radiotherapy, immunotherapy, and multitarget approaches. Mechanistic insights into esophageal carcinogenesis underscore alterations in EGFR/ErbB, PI3K/AKT/mTOR, and Notch/Wnt/β‐catenin pathways, driving proliferative and survival signaling cascades. CDKN2A, cyclin‐dependent kinase inhibitor 2A; EC, esophageal cancer; EGFR, endothelial growth factor receptor; HER2, human epidermal growth factor receptor 2; mTOR, mammalian target of rapamycin; PI3K, phosphatidylinositol 3‐kinase; TP53, tumor protein 53.
Publisher
John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
