Study opens door to treatment of oesophageal cancer

In a recent study, scientists

have discovered that oesophageal cancer can be classified into three

different subtypes, paving the way for testing targeted treatments

tailored to patients' disease for the first time.

It could help find drugs that target specific weaknesses in each

subtype of the disease, which could make treatment more effective and

boost survival.

The scientists looked at the complete genetic make-up of 129

oesophageal cancers and were able to subdivide the disease into three

distinct types based on patterns detected in the DNA of the cancer

cells called signatures.

The first subtype they found had faults in their DNA repair pathways.

Damage to this pathway is known to increase the risk of breast,

 

ovarian and prostate cancers.

Patients with this subtype may benefit from a new family of drugs,

called PARP inhibitors, that kill cancer cells by exploiting this

weakness in their ability to repair DNA.

The second subtype had a higher number of DNA mistakes and more immune

cells in the tumours, which suggests these patients could benefit from

immunotherapy drugs already showing great promise in a number of

cancer types such as skin cancer.

The final subtype had a DNA signature that is mainly associated with

the cell ageing process and means this group might benefit from drugs

targeting proteins on the surface of the cancer cells which make cells

divide.

Lead researcher Professor Rebecca Fitzgerald, said "Our study suggests

we could make changes to the way we treat oesophageal cancer. Targeted

treatments for the disease have so far not been successful, and this

is mostly down to the lack of ways to determine which patients might

benefit from different treatments. 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."

He added, "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."

Each year around 8,800 people are diagnosed with oesophageal cancer in

UK and just 12 percent survive their disease for at least 10 years.

Cancer Research UK has prioritised research into oesophageal cancer to

help more people survive the disease by bringing people together,

building infrastructure and developing the next generation of research

leaders.

Co-researcher Peter Johnson said "Being able to distinguish distinct

types of oesophageal cancer is a genuinely new discovery from this

work. For the first time we may be able to identify and test targeted

treatments designed to exploit the cancer's specific weaknesses."

He added, "Although survival rates from oesophageal cancer have been

slowly rising in the last few years they are still far too low, and

this research points the way to a completely new way of understanding

and tackling the disease."

The research was published in Nature Genetics.