Advanced gastric adenocarcinoma: optimizing therapy options
Advanced gastric adenocarcinoma: optimizing therapy options
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DOI：
10.1080/17512433.2017.1279969
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发表时间：
2017-01-01
影响因子：
4.4
通讯作者：
Ajani, Jaffer A.
中科院分区：
文献类型：
--
作者：
Kaya, Dilsa Mizrak;Harada, Kazuto;Ajani, Jaffer A.
前言：胃腺癌(GAC)是全球第五大常见癌症和第三大癌症相关死亡原因。当局部治疗时，一些患者可以通过手术和辅助治疗治愈，然而，一旦进展，GAC就不是一种可以治愈的疾病。目前只有两种靶向药物(曲妥珠单抗和雷穆鲁单抗)获得批准，阿帕替尼仅在中国获得批准。由于GAC的异质性，不可能评估标准的治疗方法。在这篇综述中，我们的目标是描述晚期GAC的最佳全身治疗方案。进行文献检索，以确定来自PubMed临床试验的所有关于晚期GAC的II-III期研究。GOV、美国临床肿瘤学会(ASCO)和欧洲医学肿瘤学会(ESMO)网站。专家评论：铂化合物和氟嘧啶的组合是理想的一线治疗方法。如果肿瘤HER2阳性，应加用曲妥珠单抗。在第二行设置中，紫杉醇/Ramucirumab优于单独使用ramucirumab。最近，对GAC提出了两种类似的分子分类。更好地了解GAC的分子和免疫生物学可以发现新的治疗靶点。
Introduction: Gastric adenocarcinoma (GAC) is the fifth most common cancer and third leading cause of cancer related mortality worldwide. When localized, cure is achievable with surgery and adjunctive therapies in some patients, however, once advanced, GAC is not a curable condition. Only two targeted agents (trastuzumab and ramucirumab) have been approved and apatinib was approved only in China. Because of the heterogeneous nature of GAC, it is not possible to assess a standard therapeutic approach.Areas covered: In this review, we aimed to describe the optimal systemic therapy regimens for advanced GAC. A literature search was performed to identify all phase II-III studies about advanced GAC from PubMed, clinicaltrials. gov, American Society of Clinical Oncology (ASCO) and European Society for Medical Oncology (ESMO) websites.Expert commentary: A combination of a platinum compound and a fluoropyrimidine is ideal as first line therapy. Trastuzumab should be added if the tumor is HER2 positive. In the second line setting, paclitaxel/ramucirumab is preferred over ramucirumab alone. Recently, two similar molecular classifications for GAC have been proposed. A better understanding of molecular and immune biology of GAC could identify new therapeutic targets.