Discussion: Upcoming GEJ Cancer and Gastric Cancer Agents and Biomarkers

In a video conversation on OncLive, Dr. Daniel Catenacci and Dr. Sam Klempner discuss new biomarkers and therapeutic agents that could have implications for the future treatment of gastric cancer and gastroesophageal junction (GEJ) cancer. Biomarkers are important indicators of disease and therapy activity and can be critical to identify for successful clinical trial and drug design.

About GEJ Cancer

Gastroesophageal junction (GEJ) cancer is an adenocarcinoma that usually affects the lower third of the esophagus. Among esophageal cancers, this form is the more prevalent type in the developed world. Risk factors include being male, acid reflux, obesity, and tobacco use. This can be a dangerous type of cancer because symptoms may not appear until the disease has reached an advanced stage, when it is less likely to be responsive to treatment. Symptoms include difficulty swallowing, pain while swallowing, pain in the chest or stomach the resembles heartburn, a hoarse cough, food regurgitation, vomiting (which can include blood), and nausea. Other symptoms may occur if cancer has metastasized to other parts of the body. Treatments for GEJ cancer may include surgery, chemo, and radiation therapy. Unfortunately, outcomes for GEJ cancer are poor; in the US, the five-year survival rate is only 15 percent for esophageal cancer as a whole. Click here to learn more about GEJ cancer.

Dr. Catenacci first mentions to of the most prominent biomarkers in GEJ cancer: claudin and fibroblast growth factor receptor 2 (FGFR2). A claudin antibody therapy was recently evaluated in a phase 2 trial which compared outcomes in patients that expressed the antibody. These patients received a chemotherapy treatment and some received the antibody therapy as well. This study showed that the claudin antibody conferred a survival benefit, particularly in patients that expressed claudin in 70 percent or more of cells. This therapy will soon be evaluated in phase 3 clinical trials.

In the case of FGFR2, a targeted therapy called bemarituzumab is in development to act on this biomarker. This drug was evaluated in a phase 2 study of GEJ cancer patients with FGFR2 positive tumors, which included amplified tumors and those that were immunohistochemistry positive. The treatment produced benefits in progression free survival and is expected to continue into phase 3 trials as well.

Check out the full conversation here.

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