Personalized targeted therapy for esophageal squamous cell carcinoma

Abstract

Esophageal squamous cell carcinoma continues to heavily burden clinicians worldwide. Researchers have discovered the genomic landscape of esophageal squamous cell carcinoma, which holds promise for an era of personalized oncology care. One of the most pressing problems facing this issue is to improve the understanding of the newly available genomic data, and identify the driver-gene mutations, pathways, and networks. The emergence of a legion of novel targeted agents has generated much hope and hype regarding more potent treatment regimens, but the accuracy of drug selection is still arguable. Other problems, such as cancer heterogeneity, drug resistance, exceptional responders, and side effects, have to be surmounted. Evolving topics in personalized oncology, such as interpretation of genomics data, issues in targeted therapy, research approaches for targeted therapy, and future perspectives, will be discussed in this editorial.

Keywords: Cancer heterogeneity; Cultured tumor cells; Driver mutation; Drug side effects; Esophageal squamous cell carcinoma; Exceptional responder; High-throughput nucleotide sequencing; Neoplasm drug resistance; Personalized medicine; Xenograft model.

Figure 1

Personalized and targeted therapy for esophageal squamous cell carcinoma. The strategy is based on the concept that a patient’s genetic makeup should guide his/her treatment. After a series of molecular analyses on tumor samples, bioinformatics is expected to identify driver genes, pathways, cancer subtype, and target drugs. A tumor board will synthesize all information and generate a personalized treatment plan. Nonresponders may be analyzed in a similar manner during subsequent surveillance and further treated. ESCC: Esophageal squamous cell carcinoma; WES: Whole exome sequencing; WGS: Whole genome sequencing.