The '–omics' revolution and oesophageal adenocarcinoma

Key Points The majority of patients with oesophageal adenocarcinoma (OAC) undergoing surgery with curative intent will relapse and eventually succumb to their disease The presence of Barrett oesophagus is a risk factor for developing OAC, although patients at the highest risk of developing OAC need to be identified So-called –omics studies have provided novel insights into OAC biology, identifying recurrent mutations and mutational signatures important in disease pathogenesis Controversy over the aetiology of gastro-oesophageal junctional tumours remains, but so-called –omics studies are providing resources to begin to subclassify this disease Nearly half of OACs have a potential actionable mutation; clinical trials using targeted therapies are in their infancy and initial experiences have been disappointing, supporting the need for more accurate molecular stratification Advances in molecular assays applied to nonendoscopic cell collection devices and blood-based biomarkers might enable noninvasive diagnosis of OAC, as well as monitoring response to different treatment regimes