Marshall Makes the Case for Molecular Sorting in Gastrointestinal Disease

Ariela Katz
Published: Tuesday, Jul 03, 2018
John L. Marshall, MD

John L. Marshall, MD
Oncologists have been slow to introduce targeted and immune therapies into the treatment of gastrointestinal (GI) cancers, but that is changing, and poor patient survival statistics call for a continuation of this trend, according to John L. Marshall, MD, chief of the Division of Hematology and Oncology and a professor of medicine and oncology at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC.

Protein expression screened by immunohistochemistry (IHC) testing also distinguished these tumors from each other in the analysis. All tumors had high expressions of EGFR, with squamous cell esophageal cancer running the highest. Squamous cell esophageal cancer also had higher expression of ERCC1, PD-L1, RRM1, TLE3, TOPO1, and TUBB3.

Table. Mutational Expression in Diffuse and Intestinal Gastric Cancers2

There is also a statistically significant difference between diffuse and intestinal tumors based on NGS testing in the analysis (Table). “We recognize diffuse and intestinal [tumors] as different anatomically, but we don’t treat them differently clinically,” Marshall said. This distinction persists in IHC testing, where intestinal tumors have higher expressions of HER2, TOP2A, TS, RRM1, and cMET.
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Oncology Briefings™: Individualizing Treatment After Second-Line Therapy for Patients With mCRCAug 29, 20191.0
Community Practice Connections™: Navigating New Sequencing Challenges for the Treatment of Hepatocellular CarcinomaAug 30, 20191.5
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