Treatment options in patients with metastatic gastric cancer: Current status and future perspectives
Treatment options in patients with metastatic gastric cancer: Current status and future perspectives
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DOI：
10.3748/wjg.v20.i14.3905
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发表时间：
2014-04-14
影响因子：
4.3
通讯作者：
Bilici, Ahmet
中科院分区：
文献类型：
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作者：
Bilici, Ahmet
尽管胃癌的治疗取得了进展，但它仍然是世界上第二大癌症死亡原因。由于胃癌通常在晚期被诊断出来，因此全身化疗是这些患者的主要治疗方法。然而，没有标准的姑息性化疗方案已被接受的转移性胃癌患者。姑息性化疗包括氟嘧啶、铂类化合物、多西他赛和表阿霉素，与最佳支持治疗相比，可提高生存率，并在更大程度上改善生活质量。与靶向药物相关的临床研究数量最近有所增加。靶向表皮生长因子受体1和人表皮生长因子受体2（HER 2）的药物已被广泛测试。曲妥珠单抗是第一个开发的靶向药物，也是关键阶段。临床试验表明，当曲妥珠单抗与顺铂/氟嘧啶为基础的化疗结合时，转移性胃癌患者的生存率提高。因此，曲妥珠单抗联合化疗被批准为HER 2阳性晚期食管胃腺癌患者的新标准治疗。因此，应考虑在所有转移性胃食管腺癌患者中评价HER 2状态。靶向血管内皮生长因子、雷帕霉素的哺乳动物靶点和其他生物学途径的其他药物也在临床试验中进行了研究，但对患者的生存率几乎没有影响。本文就转移性胃癌的一线和二线全身化疗和靶向治疗的最新进展进行综述。(C)2014百世登出版集团有限公司有限公司All rights reserved.
Despite advances in the treatment of gastric cancer, it remains the world's second highest cause of cancer death. As gastric cancer is often diagnosed at an advanced stage, systemic chemotherapy is the mainstay of treatment for these patients. However, no standard palliative chemotherapy regimen has been accepted for patients with metastatic gastric cancer. Palliative chemotherapy including fluoropyrimidine, platin compounds, docetaxel and epirubicin prolongs survival, and improves a high quality of life to a greater extent than best supportive care. The number of clinical investigations associated with targeted agents has recently increased. Agents targeting the epidermal growth factor receptor 1 and human epidermal growth factor receptor 2 (HER2) have been widely tested. Trastuzumab was the first target drug developed, and pivotal phase. trials showed improved survival when trastuzumab was integrated into cisplatin/ fluoropyrimidine-based chemotherapy in patients with metastatic gastric cancer. Trastuzumab in combination with chemotherapy was thus approved to be a new standard of care for patients with HER2-positive advanced esophagogastric adenocarcinoma. Thus, the evaluation of HER2 status in all patients with metastatic gastroesophageal adenocarcinoma should be considered. Other agents targeting vascular endothelial growth factor, mammalian target of rapamycin, and other biological pathways have also been investigated in clinical trials, but showed little impact on the survival of patients. In this review, systemic chemotherapy and targeted therapies for metastatic gastric cancer in the first- and second-line setting are summarized in the light of recent advances. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.