A pre-clinical study has found targeted drug therapy may be helpful in preventing esophageal cancer in a high-risk population. Researchers are looking at people who suffer from gastro esophageal reflux disease (GERD). Some 20 percent of Americans have at least one symptom of GERD a week that requires some sort of therapy.
“It is this disease that results in the backwards flow of acid and gastric juices into the end of the esophagus, this in turn results in chronic inflammation in patients, and that chronic inflammation causes the cancer ultimately,” said Dr. Blair Jobe, director of the Institute for the Treatment of Esophageal and Thoracic Disease at West Penn Allegheny Health System.
Though, Jobe noted, only a very small percentage of those who have GERD develop cancer. In some cases, chronic GERD causes injury to the lining of the esophagus, which can lead to a premalignant condition called Barrett’s esophagus.
Currently, when a patient does develop cancer, the strategy is to perform surveillance endoscopy, ablation procedures, or remove diseased tissue. This study has shown there may be a better way to prevent cancer using a targeted medical therapy that disables a molecular switch that puts the process of cancer development into motion.
The study was done in a large sampling of rats. GERD was surgically induced in the animals and the Smo inhibitor drug was administered orally to half of them over a period of 28 weeks. Among the subjects who received the drug there was a 36 percent lower risk of Barrett’s esophagus and a 62 percent relative risk reduction for developing esophageal cancer compared to the control group. Animal testing was just the first step.
“Next it’s our hope to put together a clinical trial in humans in which we can take a highly-selected, high-risk group of patients and utilize this medication in them in hopes we can prevent them from developing or progressing toward invasive malignancy,” said Jobe.
Part of the research is finding out who is in the highest risk population.
“Our problem is that we are trying to find these needles in this big haystack of patients with GERD. That’s where we run into problems, in that patients may not even have severe symptoms but they develop cancer,” said Jobe.
He added, this is the first demonstration of the prevention of this type of cancer in living organisms. The research done for the study was conducted when Jobe was on staff at the University of Pittsburgh. The study appears in the Annals of Surgery.