A review on biomarkers for prediction of treatment outcome in gastric cancer.
A review on biomarkers for prediction of treatment outcome in gastric cancer.
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发表时间：
2013-04
影响因子：
2
通讯作者：
F. Pietrantonio;F. D. De Braud;V. Da Prat;F. Perrone;M. Pierotti;M. Gariboldi;G. Fanetti;P. Biondani;A. Pellegrinelli;I. Bossi;M. Di Bartolomeo
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作者：
F. Pietrantonio;F. D. De Braud;V. Da Prat;F. Perrone;M. Pierotti;M. Gariboldi;G. Fanetti;P. Biondani;A. Pellegrinelli;I. Bossi;M. Di Bartolomeo
目前，胃癌的治疗管理主要基于临床数据和组织学特征。虽然最近已经引入了几种新的治疗方案，但个体间反应和耐药性的差异仍然是一个挑战。已经鉴定出许多有前途的标记物来预测预后和对治疗的反应的可能性，以便基于患者的个体特征来定制治疗方案。然而，尽管最近在基因测序和分子诊断方面取得了进展，但许多生物标志物仍然具有有争议的作用。已发表的数据通常相互矛盾，目前，除了人表皮生长因子受体2（HER 2）状态外，没有其他分子标志物进入临床实践的主流。鉴定可靠标记的主要障碍在于定量评估分子改变的技术困难;由于生物过程的复杂性，全基因组分析也常常具有误导性。然而，许多生物标志物正在临床试验中进行评估，以确定对患者进行分层的标准并建立定制的治疗方法。在这篇综述中，我们提供了一个有前途的生物预后和预测标记物的更新，重点是生长因子信号分子，DNA修复系统，氟嘧啶代谢和凋亡途径。
Currently, therapeutic management of gastric cancer is mainly based on clinical data and histological features. Although several new treatment options have recently been introduced, inter-individual variability of response and drug resistance are still a challenge. Many promising markers have been identified to predict prognosis and likelihood of response to therapy, in order to tailor treatment regimens on the basis of patients' individual features. However, despite recent developments in gene sequencing and molecular diagnostics, many biomarkers still have a controversial role. Published data are often contradictory and at the moment, no molecular marker, other than Human epidermal growth factor receptor-2 (HER2) status for trastuzumab-based treatment, has entered the mainstream of clinical practice. The primary obstacle to the identification of reliable markers lies in technical difficulties in quantitatively assessing molecular alterations; genome-wide analyses are also often misleading due to the complexity of biological processes. Nevertheless, many biomarkers are being evaluated in clinical trials in order to identify criteria for stratifying patients and establish customized therapeutic approaches. In this review, we provide an update on promising biological prognostic and predictive markers, with a focus on growth factor signalling molecules, DNA repair systems, fluoropyrimidine metabolism and apoptotic pathways.