Changing strategies for target therapy in gastric cancer
Changing strategies for target therapy in gastric cancer
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DOI：
10.3748/wjg.v22.i3.1179
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发表时间：
2016-01-21
影响因子：
4.3
通讯作者：
Oh, Sang Cheul
中科院分区：
文献类型：
--
作者：
Lee, Suk-young;Oh, Sang Cheul
尽管全球范围内胃癌的发病率有所下降，但这种恶性肿瘤仍然是癌症死亡的主要原因之一。人们在改善转移性胃癌患者的治疗结果方面做出了很大努力，曲妥珠单抗的引入极大地提高了总体生存率。曲妥珠单抗治疗迈出了开启分子靶向治疗时代的第一步，但仍有几个问题需要解决，以提高靶向治疗的疗效。首先，许多接受曲妥珠单抗联合化疗药物的转移性胃癌患者对靶向治疗产生耐药性。其次，许多临床试验证明新型分子靶向药物对其他恶性肿瘤有效，但未能显示出对转移性胃癌患者的益处，这表明在靶向药物的应用中，根据分子特征选择合适的适应症是重要的。在此，我们综述了目前批准和使用的分子靶向药物，以及在转移性胃癌患者中的临床试验，并展示了进展期胃癌治疗的局限性和未来的方向。
In spite of a worldwide decrease in the incidence of gastric cancer, this malignancy still remains one of the leading causes of cancer mortality. Great efforts have been made to improve treatment outcomes in patients with metastatic gastric cancer, and the introduction of trastuzumab has greatly improved the overall survival. The trastuzumab treatment took its first step in opening the era of molecular targeted therapy, however several issues still need to be resolved to increase the efficacy of targeted therapy. Firstly, many patients with metastatic gastric cancer who receive trastuzumab in combination with chemotherapeutic agents develop resistance to the targeted therapy. Secondly, many clinical trials testing novel molecular targeted agents with demonstrated efficacy in other malignancies have failed to show benefit in patients with metastatic gastric cancer, suggesting the importance of the selection of appropriate indications according to molecular characteristics in application of targeted agents. Herein, we review the molecular targeted agents currently approved and in use, and clinical trials in patients with metastatic gastric cancer, and demonstrate the limitations and future direction in treatment of advanced gastric cancer.