Progress in the treatment of upper gastrointestinal cancer

Upper gastrointestinal cancers (GI) include esophagus cancer (the tube that carries food from the mouth to the stomach), the stomach and the small intestine. These cancers can sometimes be difficult to treat, but new tools and drugs detect cancer earlier and help people live longer.

Jump at the main dishes to remember.

Find higher GI cancer earlier

One of the best ways to improve cancer results is to detect it early, before you can become very large or spread in different areas of the body.

Endoscopy are imaging procedures in which a camera on a flexible tube is placed in the upper gastrointestinal tract. High definition endoscopes offer a considerably clearer view of the upper digestive tract. These spans can find tiny changes in the mucosa of the esophagus or stomachs which can be cancer or precancerous cells.

Special lights and colors Can also help highlight the areas of the esophagus or stomach that can be wary of cancer. A tool called Confocal laser endomicroscopy Allows health care providers to see cells closely while the range is always inside the body. These can help determine the best areas for a biopsy (elimination of a sample to be analyzed in the laboratory for the presence of cancer cells).

Artificial Intelligence (AI) is used in some cases to help read scopes images. Computers can now help see suspicious areas that may be missed by the human eye. Although the use of AI can always be under clinical survey, it is a promising development in early detection of higher GI cancer.

Immunotherapy advances

One of the greatest progress in higher GI cancer care is the use of immunotherapy. This type of medication helps the body’s immune system to find and attack cancer cells. Some cancers develop because they can “hide” from the immune system. Immunotherapy prevents cancer from being able to hide.

In esophagus and stomach cancers, certain immunotherapy drugs are now used with chemotherapy:

• Udivo (nivolumab) Help people with esophagus cancer to live longer when used after surgery and radiation.
• Ketruda (Pembrolizumab) Can help when used with chemotherapy in some patients with advanced cancer.

Researchers also examine if immunotherapy can help before surgery. In some studies, the people who took it before surgery had smaller tumors and better recovery.

A study presented in June 2025 showed that a combination of chemotherapy and immunotherapy with Imfinzi (Durvalumab} helped reduce the risk of return of gastrointestinal cancer when given before and after surgery.

Targeted therapy advances

Not all GI cancers are genetically the same. Each cancer can have its own genetic fingerprint. Certain cancers have genetic mutations (changes) which can be treated by a drug that targets these mutations specifically.

For example, certain stomach cancers have cells that have too much protein called Human epidermal growth factor 2 (HER2). People with positive HER2 cancer can benefit from a drug led by Her2 such as Herceptin (trastuzumab).

In addition to HER2, other targeted treatments could be useful for some people. These drugs may target the ways of:

• Vascular endothelial growth factor (VEGF): a signaling protein that stimulates the formation of new blood vessels
• Neurotrophic kinase receptors of tyrosine (NTRK): mergers abnormal genes that can fuel the growth of certain cancers
• Claudin18.2 (CLDN18.2): A molecule that helps maintain epithelial cells together
• Fibroblasts growth factor receiver (FGFR): an active molecule in cell growth, differentiation, survival and migration that can contribute to the progression of certain cancers
• Receiver of the epidermal growth factor (EGFR): a protein that can cause abnormal cellular growth

Surgical techniques improvements

Surgery is always an important part of the treatment of many higher GI cancers. The purpose of surgery is usually to completely remove the tumor.

Surgergia is now often carried out using smaller incisions and using laparoscopic or robot assisted tools. These methods generally mean less pain, shorter hospital stays and faster healing:

• Laparoscopic surgery is carried out by making two small or more incisions and by inserting a camera and tools to perform surgery. It is not very invasive.
• Robot assisted surgery is carried out laparoscopically, using very small surgical tools attached to the robotic arms. A surgeon controls the robotic arms of a visualization screen rather than handling them directly.

In addition to different surgical techniques, neoadjuvant Chemotherapy or immunotherapy is now used more often. Neoadjuvant means that treatment is given before surgery to try to shrink the tumor to facilitate surgery. Chemotherapy with or without immunotherapy can continue after surgery to reduce the risk of return from cancer.

Improvements of screening and monitoring

Screening means looking for cancer before it causes symptoms, and surveillance is looking for a recurrence of cancer after being treated. For some people who are at high risk of developing higher GI cancer, periodic endoscopies can help find cancer before it starts or spreads.

Main to remember

• New tools help health care providers to detect gastrointestinal cancers earlier, including high definition glasses, specialized imaging coloring and artificial intelligence that can more precisely identify the signs of cancer.
• Immunotherapy and targeted treatments improve survival, especially when used alongside chemotherapy or before surgery to shrink tumors and reduce the risk of cancer.
• Surgery becomes safer and more effective, with less invasive techniques and better results when combined with treatments such as chemotherapy or immunotherapy before and after the operation.