Springer New Perspectives in Molecular and Clinical Management of Gastrointestinal Tumors: 142 (Recent Results in Cancer Research, 142)

Over the past few years, a wealth of new insights have been gained and put to use in basic gastrointestinal tumor research, including tumor suppressor genes, oncogenes, cell-cycle con- trol, apoptosis, adhesion receptors, signal transduction, and gene therapy. Similarly, progress has been made in preven- tion, molecular diagnosis, laparoscopic staging, and antibody- based immunotherapy, and new drugs such as thyrnidylate and topoisomerase I inhibitors have been developed espe- cially for the treatment of colorectal carcinoma. Despite this burgeoning of knowledge in both basic and clinical research, however, we have just begun to put these results into clinical practice. Therefore, the key goal of this volume is to bring together basic and clinical research findings so as to facilitate the translation of these advances into the clinical manage- ment of gastrointestinal tumors. We hope that this volume, which covers a broad spectrum of research and clinical medicine, will impart new insights and greater understanding to all those interested in the therapy of gastrointestinal tumors and will stimulate further scientific research. Berlin, January 1996 E. D. Kreuser P. M. Schlag Contents 1 I. Basic Research S. J. Meltzer The Molecular Biology of Esophageal Carcinoma 1 E. R. Greenberg Preventing Colorectal Cancer...9 M. Streit, R. Schmidt, R. U. Hi/genfeld, E. Thiel, and E. -D. Kreuser Adhesion Receptors in Malignant Transformation and Dissemination of Gastrointestinal Tumors...19 R. Kaiser, E. Thiel, and E. -D. Kreuser Human Gene Therapy in Gastrointestinal Diseases: In Vivo and In Vitro Approaches ... From the Back Cover This volume focuses on new and exciting approaches in the molecular and clinical management of gastrointestinal tumors. The first part presents recent insights into carcinogenesis, including alterations in cyclins and adhesion receptors, molecular structures which might be new targets of gene therapy. The second part of the volume offers new diagnostic tools, such as receptors for gastrointestinal hormones, proliferation markers, tumor suppressor proteins, and the multiple drug resistance gene, predicting response to therapy and prognosis in gastrointestinal tumors. The third part gives an update of successful approaches in primary and secondary prevention of colorectal carcinoma. Nutritional factors and pharmacologic agents can clearly decrease the risk, and fecal occult blood tests and endoscopy can reduce the mortality in colorectal carcinoma. Laparoscopic staging with subsequent biopsy of suspicious lymph nodes provides essential information in esophageal and gastric cancer. In locally advanced gastric cancer, preoperative chemotherapy provides sufficient evidence to investigate this approach as compared to primary surgery. Standards have recently been established in the adjuvant treatment of patients with gastrointestinal carcinoma, and promising new drugs, including monoclonal antibodies, thymidylate synthase, and topoisomerase inhibitors, as well as taxoids, are currently being tested in phase I, II, and III trials of gastrointestinal tumors.