A study published in Nature Genetics claims that esophageal cancer may in fact be 3 distinct diseases, which could pave the way for new methods of diagnosis and spur the development of targeted treatment regimens.
Despite a number of targeted therapy trials, the prognosis for esophageal adenocarcinoma remains poor, due in large part to a lack of robust stratification methods. Therefore, scientists funded by Cancer Research UK and the Medical Research Council analyzed the complete genetic make-up of 129 esophageal cancers. They discovered that the disease could be subdivided into 3 distinct types based on the signatures of cancer cells.
The first subtype was characterized by faults in DNA repair pathways, which have been associated with an increased risk of breast, ovarian, and prostate cancers. Therefore, patients with this type of esophageal cancer may benefit from a new line of drugs called PARP (poly ADP ribose polymerase) inhibitors, which work by hampering the ability of cancer cells to repair DNA.
The second subtype had a higher number of DNA mistakes and more immune cells in tumors, which suggest that this type could benefit from the immunotherapy drugs that have recently demonstrated profound success in other cancer forms of cancer.
The final subtype had a DNA signature associated with the cell aging process, meaning that drugs targeting proteins on the surface of cancer cells would most likely be the best course of action for patients with this disease type.
Researchers concluded that these subtypes could be determined using clinical applicable treatment strategies and then used to guide the selection or development of target therapies.
“These new findings give us a greater understanding of the DNA signatures that underpin different subtypes of the disease and means we could better tailor treatment,” said lead researcher Rebecca Fitzgerald, University of Cambridge, United Kingdom. “The next step is to test this approach in a clinical trial. The trial would use a DNA test to categorise patients into one of the three groups to determine the best treatments for each group and move away from a one-size-fits-all approach.”
