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MedUni Vienna researchers discover new possibilities for treating oesophageal cancer

(Vienna, 27th May 2011) Researchers at the Medical University of Vienna have made crucial discoveries about the HER-2 gene and its key role in the development of tumours in the oesophagus. These promise to improve the treatment and survival rates of affected patients.

Carcinoma of the oesophagus is usually a highly aggressive disease, and the frequency of adenocarcinoma in the glandular tissue of the oesophagus has risen markedly in recent years.  The therapeutic options currently remain very limited, especially for advanced cases.

The recently-published study results from researchers at the Medical University of Vienna reveal a promising potential line of attack on the HER-2 gene (human epidermal growth factor receptor 2). The proteins produced by the HER-2 gene have been found to exhibit strong cancer-promoting properties. These, however, can now be treated with medication.

Existing drugs may be able to help
Researchers discovered that HER-2 proteins are present in significantly higher numbers in around 15% of the adenocarcinomas of the oesophagus. This means that effective drugs against the HER-2 effects could also be used in this case. Until now, these types of drugs have been licensed for stomach cancer, but not for treating non-metastatic oesophageal cancers. This is incorrect, as a further study result shows. HER-2 activity does not increase with the formation of metastases. In fact, the latest research results show that the gene’s status remains constant. This means that the conventional practice of performing metastatic biopsies is superfluous, since the tissue can also be obtained from the main tumour. This would at least spare affected patients from a very difficult procedure.

The scientists also demonstrated that HER-2 can work in various different ways. Proof has been found, for example, that HER-2 is closely linked to the increased formation of carboanhydrase. This causes human tissue to respond as though it were being starved of oxygen. This increases the cells’ aggressiveness, causing the development of tumours. According to the scientists, this tight feedback mechanism may also be a promising route of attack for drug therapy.

Interdisciplinary collaboration with international acknowledgement
The researchers also credit the discovery of these important findings to the excellent collaboration between various institutions at the MedUni Vienna. The three individual studies were carried out in the Upper GI Research Unit of the surgical research laboratory in collaboration with the Cancer Comprehensive Center (CCC Vienna) in a cooperation agreement with the Clinical Institute of Pathology (University Professor Peter Birner) and the University Department of Surgery (University Professor Sebastian Schoppmann, Head of the Upper GI Research Unit) at the Medical University of Vienna.

The importance of the results is also reflected by their publication in the internationally-renowned "American Journal of Surgery Pathology", “British Journal of Surgery” and “Annals of Surgical Oncology”.

» Publication in the “American Journal of Surgical Pathology”:
Expression of Her-2 in Carcinomas of the Esophagus
S. F. Schoppmann, B. Jesch, J. Friedrich, F. Wrba, A. Schultheis, U. Pluschnig, J. Maresch, J. Zacherl, M. Hejna, P. Birner
Am J Surg Pathol. 2010 Dec;34(12):1868-73.

» Publication in the “British Journal of Surgery” (online first publication):

Her-2 status in primary esophageal cancer and corresponding lymph-node and distant metastases
S.F. Schoppmann, B. Jesch, J. Zacherl, F. Wrba, M. Hejna, J. Maresch, F. Langer,
MF.  Riegler, U. Pluschnig, P. Birner
DOI: 10.1002/bjs.7562

» Publication in the “Annals of Surgical Oncology” (online first publication):
Carbonic Anhydrase IX-overexpression is associated with diminished prognosis in esophageal cancer and correlates with Her-2 expression
P. Birner, B. Jesch, J. Friedrich, M. Riegler, J. Zacherl, M. Hejna, F. Wrba, A. Schultheis, S. F. Schoppmann.
PMID: 21519917