Bringing molecular tests to GI cancer clinics: Barrett’s and oesophageal adenocarcinoma

Rebecca Fitzgerald

Professor Fitzgerald is a tenured Programme Leader at the MRC Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge and Honorary Consultant in Gastroenterology and Oncology at Addenbrooke’s Hospital. The focus of her research is to improve methods for early detection of oesophageal cancer through better understanding of the molecular pathogenesis, including: the genetic determinants of Barrett’s oesophagus and oesophageal cancer; endoscopic and non-endoscopic screening for pre-cancerous conditions of the upper GI tract; clinical and molecular biomarkers in Barrett’s oesophagus; and novel therapeutic targets for the treatment of oesophago-gastric cancer.

Professor Rebecca Fitzgerald

Bringing molecular tests to GI cancer clinics: Barrett’s and oesophageal adenocarcinoma

Barrett’s oesophagus and oesophageal adenocarcinoma have increased rapidly in parts of Europe over the past 30 years and patient outcomes remain dismal. DNA sequencing studies have shown for the first time that Barrett’s metaplasia is a highly mutated epithelium even prior to the development of dysplasia. There are multiple pathways by which Barrett’s can progress to cancer but copy number alteration is a common hallmark which defines the malignant transition. Our growing understanding of these changes can be utilised in molecular tests for early diagnosis. With regards to treatment, despite a lack of driver genes to guide molecular targeted therapy, subgroups are emerging which might help to define alternative strategies. Our current understanding of this condition and how the rapidly accumulating genomic data might be applied to the clinic will be discussed.