SNFGE SNFGE
 
Thématique :
- Cancers autres (hors CCR et CHC)
Originalité :
Réexamen
Solidité :
Très solide
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Docteur Roger FAROUX
Coup de coeur :
 
 
Gastroenterology
  2018/01  
 
  2018 Jan;154(2):437-451.  
  doi: 10.1053/j.gastro.2017.09.048  
 
  Management of Patients With Adenocarcinoma or Squamous Cancer of the Esophagus.  
 
  Ilson DH, van Hillegersberg R  
  https://www.ncbi.nlm.nih.gov/pubmed/29037469  
 
 

Abstract

Esophageal cancer is characterized by early and frequent metastasis. Surgery is the primary treatment for early-stage disease, whereas patients with patients with locally advanced disease receive perioperative chemotherapy or chemoradiotherapy. Squamous cancers can be treated with primary chemoradiotherapy without surgery, depending on their response to therapy and patient tolerance for subsequent surgery. Chemotherapy with a fluorinated pyrimidine and a platinum agent, followed by later treatment with taxanes and irinotecan, provides some benefit. Agents that inhibit the erb-b2 receptor tyrosine kinase 2 (ERBB2 or HER2), or vascular endothelial growth factor, including trastuzumab, ramucirumab, and apatinib, increase response and survival times. Esophageal adenocarcinomas have mutations in tumor protein p53 and mutations that activate receptor-associated tyrosine kinase, vascular endothelial growth factor, and cell cycle pathways, whereas esophageal squamous tumors have a distinct set of mutations. Esophageal cancers develop systems to evade anti-tumor immune responses, but studies are needed to determine how immune checkpoint modification contributes to esophageal tumor development.

 

 
Question posée
 
Prise en charge des cancers de l’œsophage.
 
Question posée
 
Mise au point.
 
Commentaires

Cette mise au point est issue d’un numéro special de GASTROENTEROLOGY ( Volume 154, issue 2 Jan 2018) sur les maladies de l’oesophage et entre autres le cancer de l’oesophage, adénocarcinomes et épidermoides, 6 articles allant de l’épidémiologie à la thérapeutique .

Indispensable !

 
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