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World J Clin Oncol. Jun 10, 2016; 7(3): 284-292
Published online Jun 10, 2016. doi: 10.5306/wjco.v7.i3.284
Neoadjuvant therapy for gastroesophageal adenocarcinoma
Emmanuelle Samalin, Marc Ychou
Emmanuelle Samalin, Marc Ychou, Digestive Oncology Department, Institut régional du Cancer de Montpellier (ICM), 34298 Montpellier, France
Author contributions: Both Samalin E and Ychou M designed the review and defined the plan and the issues discussed; Samalin E wrote the manuscript; Samalin E and Ychou M revised the manuscript and approved the final version.
Conflict-of-interest statement: Emmanuelle Samalin has received fees for serving as consultant for Roche and Lilly laboratories. Marc Ychou has received fees for serving as consultant for Roche, Lilly and Bayer laboratories.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Emmanuelle Samalin, MD, Digestive Oncology Department, Institut régional du Cancer de Montpellier (ICM), 208 avenue des Apothicaires, 34298 Montpellier, France. emmanuelle.samalin@icm.unicancer.fr
Telephone: +33-4-67613136 Fax: +33-4-67613022
Received: July 29, 2015
Peer-review started: July 31, 2015
First decision: September 28, 2015
Revised: March 24, 2016
Accepted: April 7, 2016
Article in press: April 11, 2016
Published online: June 10, 2016
Abstract

Gastric and esophageal adenocarcinomas are one of the main causes of cancer-related death worldwide. While the incidence of gastric adenocarcinoma is decreasing, the incidence of gastroesophageal junction adenocarcinoma is rising rapidly in Western countries. Considering that surgical resection is currently the major curative treatment, and that the 5-year survival rate highly depends on the pTNM stage at diagnosis, gastroesophageal adenocarcinoma management is very challenging for oncologists. Several treatment strategies are being evaluated, and among them systemic chemotherapy, to decrease recurrences and improve overall survival. The MAGIC and FNCLCC-FFCD trials showed a survival benefit of perioperative chemotherapy in patients with operable gastric and lower esophageal cancer, and these results had an impact on the European clinical practice. New strategies, including induction chemotherapy followed by preoperative chemoradiotherapy, targeted therapies in combination with perioperative chemotherapy and the new cytotoxic regimens, are currently assessed to improve current standards and help developing patient-tailored therapeutic interventions.

Keywords: Gastric adenocarcinoma, Lower esophagus adenocarcinoma, Gastroesophageal junction adenocarcinoma, Preoperative treatment, Neoadjuvant treatment

Core tip: Gastric and esophageal adenocarcinomas are one of the main causes of cancer-related death worldwide. The incidence of gastroesophageal junction adenocarcinoma is rapidly rising in Western countries. Surgical resection is currently the major curative treatment. As the 5-year survival rate highly depends on the pTNM stage, the treatment strategy is very challenging for oncologists. Several treatments, including systemic chemotherapy, are being assessed to prevent recurrences and improve overall survival. New strategies, such as induction chemotherapy followed by preoperative chemoradiotherapy, targeted therapies and new cytotoxic regimens in perioperative chemotherapy, are currently assessed to improve current standards and develop more tailored therapeutic interventions.