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Advances in Neoadjuvant Chemotherapy or Chemoradiotherapy to Treat (Esophago-)Gastric Cancer...
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Advances in Neoadjuvant Chemotherapy or Chemoradiotherapy to Treat (Esophago-)Gastric Cancer or Colorectal Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (15 December 2022) | Viewed by 8683

Special Issue Editors

Dr. Keisuke Uehara

E-Mail Website
Guest Editor
Nagoya University Graduate School of Medicine, Nagoya, Japan
Interests: clinical oncology; surgery
Dr. Jaw-Yuan Wang

E-Mail Website
Guest Editor
College of Medicine, Kaohsiung, Taiwan
Interests: colon resection; colorectal surgery; chemoradiotherapy
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Ming-Yii Huang

E-Mail Website
Guest Editor
Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Interests: radiotherapy; cancer biomarkers; molecular oncology
Dr. Andrew Wang

E-Mail Website
Guest Editor
Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Interests: cancer biology; clinical oncology; cancer cell biology

Special Issue Information

Dear Colleagues, 

Significant advances have been made in the integration of chemotherapy and radiotherapy for the treatment of patients with localized (esophago-)gastric or colorectal malignancies. The therapeutic goal of chemotherapy or chemoradiotherapy is to enhance local control, resulting in improving the oncological outcomes of these patients. Neoadjuvant chemotherapy or chemoradiotherapy may be effective in downstaging tumors, thereby rendering radical resection and adjacent organ preservation possible. Apart from the well-known benefits of neoadjuvant chemotherapy or chemoradiotherapy for localized gastric cancer or colorectal cancer, the oncological outcomes of individual tumors to neoadjuvant chemotherapy or chemoradiotherapy are still variable. To define the optimal sequence and efficacy of chemotherapy and radiation, experts have made efforts to conduct advanced clinical or basic studies on malignancies of the stomach, colon and rectum. The controversies and potential future directions in the chemotherapy or chemoradiotherapy of selected gastrointestinal malignancies remain unclear. The aim of this Special Issue is to highlight researchers’ recent significant pilot or meta-analysis results related to different chemotherapy or chemoradiotherapy modalities, including chemotherapeutic agents combined with innovative radiotherapeutic techniques to increase tumor responses and pathological responses, reduce toxicity and improve oncological outcomes, or to explore the possible biomarkers to predict the outcomes (especially the pathological complete response rate) of chemotherapy or chemoradiotherapy in (esophago-)gastric cancer or colorectal cancer.

Dr. Keisuke Uehara
Dr. Jaw-Yuan Wang
Prof. Dr. Ming-Yii Huang
Dr. Andrew Wang
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • (esophago-)gastric cancer
  • colorectal cancer
  • chemotherapy
  • chemoradiotherapy
  • pathological complete response

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Published Papers (3 papers)

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Research

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20 pages, 2008 KiB  
Article
HIF-1α Expression Increases Preoperative Concurrent Chemoradiotherapy Resistance in Hyperglycemic Rectal Cancer
by Yi-Jung Huang, Yi-Ting Chen, Chun-Ming Huang, Shih-Hsun Kuo, Yan-You Liao, Wun-Ya Jhang, Shuo-Hung Wang, Chien-Chih Ke, Yu-Hsiang Huang, Chiu-Min Cheng, Ming-Yii Huang and Chih-Hung Chuang
Cancers 2022, 14(16), 4053; https://doi.org/10.3390/cancers14164053 - 22 Aug 2022
Cited by 5 | Viewed by 2585
Abstract
Purpose: Preoperative concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced rectal cancer patients. However, the poor therapeutic efficacy of CCRT was found in rectal cancer patients with hyperglycemia. This study investigated how hyperglycemia affects radiochemotherapy resistance in rectal cancer. Methods and [...] Read more.
Purpose: Preoperative concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced rectal cancer patients. However, the poor therapeutic efficacy of CCRT was found in rectal cancer patients with hyperglycemia. This study investigated how hyperglycemia affects radiochemotherapy resistance in rectal cancer. Methods and Materials: We analyzed the correlation between prognosis indexes with hypoxia-inducible factor-1 alpha (HIF-1α) in rectal cancer patients with preoperative CCRT. In vitro, we investigated the effect of different concentrated glucose of environments on the radiation tolerance of rectal cancers. Further, we analyzed the combined HIF-1α inhibitor with radiation therapy in hyperglycemic rectal cancers. Results: The prognosis indexes of euglycemic or hyperglycemic rectal cancer patients after receiving CCRT treatment were investigated. The hyperglycemic rectal cancer patients (n = 13, glycosylated hemoglobin, HbA1c > 6.5%) had poorer prognosis indexes. In addition, a positive correlation was observed between HIF-1α expression and HbA1c levels (p = 0.046). Therefore, it is very important to clarify the relationship between HIF-1α and poor response in patients with hyperglycemia receiving pre-operative CCRT. Under a high glucose environment, rectal cancer cells express higher levels of glucose transport 1 (GLUT1), O-GlcNAc transferase (OGT), and HIF-1α, suggesting that the high glucose environment might stimulate HIF-1α expression through the GLUT1-OGT-HIF-1α pathway promoting tolerance to Fluorouracil (5-FU) and radiation. In the hyperglycemic rectal cancer animal model, rectal cancer cells confirmed that radiation exposure reduces apoptosis by overexpressing HIF-1α. Combining HIF-1α inhibitors was able to reverse radioresistance in a high glucose environment. Lower HIF-1α levels increased DNA damage in tumors leading to apoptosis. Conclusions: The findings here show that hyperglycemia induces the expression of GLUT1, OGT, and HIF-1α to cause CCRT tolerance in rectal cancer and suggest that combining HIF-1α inhibitors could reverse radioresistance in a high glucose environment. HIF-1α inhibitors may be useful for development as CCRT sensitizers in patients with hyperglycemic rectal cancer. Full article
(This article belongs to the Special Issue Advances in Neoadjuvant Chemotherapy or Chemoradiotherapy to Treat (Esophago-)Gastric Cancer or Colorectal Cancer)
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Review

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19 pages, 818 KiB  
Review
MicroRNAs as Predictive Biomarkers in Patients with Colorectal Cancer Receiving Chemotherapy or Chemoradiotherapy: A Narrative Literature Review
by I-Ping Yang, Kwan-Ling Yip, Yu-Tang Chang, Yen-Cheng Chen, Ching-Wen Huang, Hsiang-Lin Tsai, Yung-Sung Yeh and Jaw-Yuan Wang
Cancers 2023, 15(5), 1358; https://doi.org/10.3390/cancers15051358 - 21 Feb 2023
Cited by 7 | Viewed by 2297
Abstract
Colorectal cancer (CRC) is one of the most common malignancies and is associated with high mortality rates worldwide. The underlying mechanism of tumorigenesis in CRC is complex, involving genetic, lifestyle-related, and environmental factors. Although radical resection with adjuvant FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) [...] Read more.
Colorectal cancer (CRC) is one of the most common malignancies and is associated with high mortality rates worldwide. The underlying mechanism of tumorigenesis in CRC is complex, involving genetic, lifestyle-related, and environmental factors. Although radical resection with adjuvant FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) chemotherapy and neoadjuvant chemoradiotherapy have remained mainstays of treatment for patients with stage III CRC and locally advanced rectal cancer, respectively, the oncological outcomes of these treatments are often unsatisfactory. To improve patients’ chances of survival, researchers are actively searching for new biomarkers to facilitate the development of more effective treatment strategies for CRC and metastatic CRC (mCRC). MicroRNAs (miRs), small, single-stranded, noncoding RNAs, can post-transcriptionally regulate mRNA translation and trigger mRNA degradation. Recent studies have documented aberrant miR levels in patients with CRC or mCRC, and some miRs are reportedly associated with chemoresistance or radioresistance in CRC. Herein, we present a narrative review of the literature on the roles of oncogenic miRs (oncomiRs) and tumor suppressor miRs (anti-oncomiRs), some of which can be used to predict the responses of patients with CRC to chemotherapy or chemoradiotherapy. Moreover, miRs may serve as potential therapeutic targets because their functions can be manipulated using synthetic antagonists and miR mimics. Full article
(This article belongs to the Special Issue Advances in Neoadjuvant Chemotherapy or Chemoradiotherapy to Treat (Esophago-)Gastric Cancer or Colorectal Cancer)
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15 pages, 321 KiB  
Review
Neoadjuvant Chemoradiotherapy for Locally Advanced Gastric Cancer: Where Are We at?
by Jen-Hao Yeh, Yung-Sung Yeh, Hsiang-Lin Tsai, Ching-Wen Huang, Tsung-Kun Chang, Wei-Chih Su and Jaw-Yuan Wang
Cancers 2022, 14(12), 3026; https://doi.org/10.3390/cancers14123026 - 20 Jun 2022
Cited by 11 | Viewed by 2989
Abstract
Locally advanced gastric cancer (LAGC) has a poor prognosis with surgical resection alone, and neoadjuvant treatment has been recommended to improve surgical and oncological outcomes. Although neoadjuvant chemotherapy has been established to be effective for LAGC, the role of neoadjuvant chemoradiotherapy (NCRT) remains [...] Read more.
Locally advanced gastric cancer (LAGC) has a poor prognosis with surgical resection alone, and neoadjuvant treatment has been recommended to improve surgical and oncological outcomes. Although neoadjuvant chemotherapy has been established to be effective for LAGC, the role of neoadjuvant chemoradiotherapy (NCRT) remains under investigation. Clinical experience and research evidence on esophagogastric junction adenocarcinoma (e.g., cardia gastric cancers) indicate that the likelihood of achieving sustainable local control is higher through NCRT than through resection alone. Furthermore, NCRT also has an acceptable treatment-related toxicity and adverse event profile. In particular, it increases the likelihood of achieving an R0 resection and a pathological complete response (pCR). Moreover, NCRT results in higher overall and recurrence-free survival rates than surgery alone; however, evidence on the survival benefits of NCRT versus neoadjuvant chemotherapy (NCT) remains conflicting. For noncardia gastric cancer, the efficacy of NCRT has mostly been reported in retrospective studies, and several large clinical trials are ongoing. Consequently, NCRT might play a more essential role in unresectable LAGC, for which NCT alone may not be adequate to attain disease control. The continual improvements in systemic treatments, radiotherapy techniques, and emerging biomarkers can also lead to improved personalized therapy for NCRT. To elucidate the contributions of NCRT to gastric cancer treatment in the future, the efficacy, potential toxicity, predictive biomarkers, and clinical considerations for implementing NCRT in different types of LAGC were reviewed. Full article
(This article belongs to the Special Issue Advances in Neoadjuvant Chemotherapy or Chemoradiotherapy to Treat (Esophago-)Gastric Cancer or Colorectal Cancer)
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