The coming of age: immunotherapy in gastrointestinal malignancies

Gastrointestinal (GI) cancers, including colorectal cancer (CRC), gastric-esophageal cancer (GEC), pancreatic adenocarcinoma (PAC), hepatocellular cancer (HCC) and cholangiocarcinoma (CCA), remain a major health problem worldwide. If detected early, given advancements in diagnostic strategies and multimodality therapeutic approaches with surgical resection, chemotherapy and/or radiation therapy, improvement in long term survival has been observed. Despite progress, 1 in 4 patients still present with advanced metastatic disease at diagnosis and many of these patients have reported median survivals less than a year. Over the last decade novel targeted agents when incorporated with chemotherapy help extend survival of patients with metastatic GI cancers. These agents include EGFR/HER-2 and VEGFR targeted agents (cetuximab, panitumumab, bevacizumab, aflibercept, and regorafenib for CRC; trastuzumab and ramucirumab for GEC; and sorafenib for HCC). Despite these advances, many patients with advanced GI cancers, succumb to their disease thus, it is imperative to develop novel therapeutic approaches for patients affected by those cancers