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World J Gastroenterol. Jun 21, 2011; 17(23): 2781-2790
Published online Jun 21, 2011. doi: 10.3748/wjg.v17.i23.2781
Targeting key signalling pathways in oesophageal adenocarcinoma: A reality for personalised medicine?
Richard R Keld, Yeng S Ang
Richard R Keld, Yeng S Ang, Department of Gastroenterology, Royal Albert Edward Infirmary, Wigan Lane, Wigan, Greater Manchester, WN1 2NN, United Kingdom
Richard R Keld, Yeng S Ang, School of Translational Medicine, Faculty of Medical and Human Sciences, The University of Manchester, Manchester, M13 9PL, United Kingdom
Author contributions: Keld RR reviewed and searched the literature; Ang YS conceived the idea and revised this paper.
Supported by UK National Institute of Health Research/Cancer Research Network (UK NIHR/UKCRN) and Research and Development Department of Wrightington Wigan and Leigh NHS Foundation Trust (to Ang YS); R Keld Wrightington Wigan and Leigh NHS Foundation Trust Cancer Therapy Fund (to Keld RR, in part)
Correspondence to: Dr. Yeng S Ang, MD, FRCP, FRCPI, FEBG, Consultant Gastroenterologist/Honorary Senior Lecturer, Department of Gastroenterology, Royal Albert Edward Infirmary, Wigan Lane, Wigan, Greater Manchester WN1 2NN, United Kingdom. yeng.ang@wwl.nhs.uk
Telephone: +44-1942-773119 Fax: +44-1942-822340
Received: April 17, 2010
Revised: July 20, 2010
Accepted: July 27, 2010
Published online: June 21, 2011

Cancer treatments are rapidly changing. Curative treatment for oesophageal adenocarcinoma currently involves surgery and cytotoxic chemotherapy or chemoradiotherapy. Outcomes for both regimes are generally poor as a result of tumor recurrence. We have reviewed the key signalling pathways associated with oesophageal adenocarcinomas and discussed the recent trials of novel agents that attempt to target these pathways. There are many trials underway with the aim of improving survival in oesophageal cancer. Currently, phase 2 and 3 trials are focused on MAP kinase inhibition, either through inhibition of growth factor receptors or signal transducer proteins. In order to avoid tumor resistance, it appears to be clear that targeted therapy will be needed to combat the multiple signalling pathways that are in operation in oesophageal adenocarcinomas. This may be achievable in the future with the advent of gene signatures and a combinatorial approach.

Keywords: Oesophageal adenocarcinoma, Signalling pathways, MAP and PI3 Kinase pathways, Wnt signalling, Transforming growth factor-β pathway, Nuclear factor-κB pathways, Transcription factors, Tyrosine kinase receptors