Noncolorectal gastrointestinal cancers — including gastric, esophageal, pancreatic, hepatocellular, biliary tract, and neuroendocrine tumors — are often diagnosed late and carry poor survival rates. Despite rising global burden, advances in precision oncology, immunotherapy, and multimodal treatment strategies are slowly shifting outcomes. Still, complications like cachexia, malnutrition, and late-stage presentation remain major barriers.
Key Takeaways
- H. pylori and gastric cancer: Certain H. pylori strains producing colibactin-like genotoxins directly damage DNA, offering a new risk-stratification and prevention pathway.
- Biliary tract cancers: Genomic profiling reveals actionable mutations in ~45% of patients; targeted therapies like FGFR inhibitors and IDH1 blockers are improving survival.
- Esophageal SCC: FDA approval of tislelizumab (PD-1 inhibitor) plus chemotherapy sets a new frontline standard for advanced ESCC.
- Hepatocellular carcinoma: Combining TACE with PD-1 and VEGF inhibitors significantly prolongs progression-free survival, signaling a trend toward multimodal therapy.
- Cancer cachexia: Still one of the most difficult complications, but early IL-6 blockade trials show promise in preserving muscle mass and treatment tolerance.