Cancer Genetics and Epigenetics, 2025, Vol.13, No.2, 62-76 http://medscipublisher.com/index.php/cge 69 7.2 Signals for predicting therapeutic effects Finding something that can predict the therapeutic effect in advance can greatly improve the therapeutic effect of esophageal adenocarcinoma (EAC). After studying genes, scientists have discovered that changes in some genes can determine whether a treatment method works or not. For instance, more than half of EAC patients have some genetic changes in their bodies, which makes drugs (inhibitors) against CDK4/CDK6 potentially effective. That is to say, precise strike treatment with this medicine for these patients should be feasible (Frankell et al., 2018). In addition, the genes that control cell division have changed. The deletion of the CDKN2Bgene and the increase of the CDK6 gene are both related to the poor effect of radiotherapy and chemotherapy. This indicates that the changes in these genes can help doctors tailor specific treatment plans for patients (Li et al., 2021). Patients with problems in the ERBB2 gene often do not live long, which indicates that patients with such genetic problems may require stronger or different treatments (Kato et al., 2018) 7.3 The role of genetic alterations in prognosis Genetic changes have a significant impact on the rehabilitation of patients with EAC. Studies show that specific genetic variations and changes at the genetic level are closely related to the rehabilitation effect of patients. For example, among EAC patients, those with missense variations in the TP53 gene usually have a poorer cancer-related survival situation, which makes the TP53 gene an important indicator for judging the recovery of patients (Orsini et al., 2023). Furthermore, the discovery of driver mutations in key genes such as SMAD4 and GATA4 implies that the recovery of patients may not be good, which provides an important reference for doctors to classify and manage patients (Frankell et al., 2018). The newly discovered oncogenes such as ANO1 are associated with poor recovery in patients with esophageal squamous cell carcinoma (ESCC), which further demonstrates the importance of analyzing genetic characteristics in predicting the recovery of patients (Yu et al., 2019). After a comprehensive study of the data on gene methylation, gene expression and gene composition, it was also found that there are different types of EAC and their recovery conditions are also different, which reflects the complexity and diversity of this type of cancer, EAC (Jammula et al., 2020). 8 Targeted Therapy and Personalized Medicine 8.1 Current targeted therapy based on genetic insights The current targeted therapy for esophageal adenocarcinoma (EAC) is developed based on specific genetic changes in the tumor. One of the highly watched targeted drugs is trastuzumab, which is specifically used to treat patients with positive human epidermal growth factor receptor 2 (HER2). This therapy has a certain effect and can prolong the average survival time of patients by approximately 2.7 months (Pectasides et al., 2016). There are also some other targeted therapeutic drugs, such as inhibitors targeting epidermal growth factor receptor (EGFR), fibroblast growth factor receptor 2 (FGFR2), and MET. Some have also been studied, but in clinical trials, their effects are mostly not very satisfactory (Pectasides et al., 2016). 8.2 New therapeutic goals Researchers studied genes and how they operate together and found a new target for dealing with esophageal adenocarcinoma (EAC). For instance, recent research suggests that dealing with genes related to body defense (immunity), such as LIF, C1QA and TREM2, might prevent the cells of EAC from growing (Souza et al., 2018). In addition, genetic research has also found that something called receptor tyrosine kinase, along with the series of reactions that follow it, has become too active. This indicates that they may also be the targets of new drugs (Souza et al., 2018). There are also some seemingly promising targets, such as drugs against CDK4/6, drugs against PARP, and drugs specifically targeting the NRF2 and Wnt signaling response chains (Hassanabad et al., 2019). 8.3 Personalized treatment methods With the improvement of genetic testing techniques and the advancement of research methods using patients' own cells, customized treatment plans for EAC are becoming increasingly useful. For instance, doctors use endoscopes to remove patients' cells and cultivate a small model (organoid) in the laboratory, which can imitate the appearance and genetic characteristics of the original tumor cells. In this way, different drugs can be tried for each
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