Advancement in Chemotherapy and Molecular Targeted Therapy of Advanced Gastric Cancer
-
摘要: 目前化疗仍然是晚期胃癌的主要治疗手段, 但尚无标准方案。与最佳支持治疗相比, 化疗可延长患者中位生存期, 提高其生存质量。近年来, 随着各种新型抗癌药物的出现, 化疗方案不断演进, 晚期胃癌的治疗有效率和生存期得到进一步提高。同时, 随着胃癌分子生物学研究的不断深入, 针对人表皮生长因子受体2(HER-2)、表皮生长因子受体(EGFR)、血管内皮生长因子(VEGF)的分子靶向治疗成为胃癌综合治疗的热点。化疗联合分子靶向治疗在晚期胃癌中显示出良好的治疗效果及前景, 但仍需在临床研究和实践中进一步调整和优化。本文将结合最新文献, 对晚期胃癌的化疗及分子靶向治疗进行综述。Abstract: Chemotherapy is still the role treatment in advanced gastric cancer by now, but no standard approach has been adopted. Chemotherapy can prolong median overall survival and improve quality of life compared with the best supportive care alone. Recent years, with the emergence of various new agents, chemotherapy regimens continuous improvement. As a result, the response rate and overall survival of advanced gastric cancer being further improved. Meanwhile, with a greater understanding of the molecular biolo- gy of gastric cancer, molecular biological targeted therapies that target HER-2, EGFR and VEGF become the focus of the comprehensive treatment. Chemotherapy combined targeted therapy have shown great benefit and perspective in treatment of advanced gastric cancer, but their usage should be fiarther modified and optimized in clinical trials and practices.
-
[1] Wagner AD, Unverzagt S, Grothe W, et al. Chemotherapy for advanced gastric cancer[J]. Cochrane Database Syst Rev, 2010, 3: CD004064. http://www.onacademic.com/detail/journal_1000040180829710_93ed.html [2] Power DG, Kelsen DP, Shah MA. Advanced gastric cancer-slow but steady progress[J]. Cancer Treat Rev, 2010, 36(5): 384-392. doi: 10.1016/j.ctrv.2010.01.005 [3] Koizumi W, Narahara H, Hara T, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a Phase 3 trial[J]. Lancet Oncol, 2008, 9(3): 215-221. doi: 10.1016/S1470-2045(08)70035-4 [4] Yun J, Lee J, Park SH, et al. A randomised Phase 2 study of combination chemotherapy with epirubicin cisplatin and capecitabine (ECX) or cisplatin and capecitabine (CX) in advanced gastric cancer[J]. Eur J Cancer, 2010, 46(5): 885-891. doi: 10.1016/j.ejca.2009.12.015 [5] Pozzo C, Ohashi Y. Meta-analysis of randomized trials assessing the influence of chemotherapy and prognostic factor in advanced/recurrent gastric cancer[J]. J Clin Oncol, 2009, 27(15): Abstract 4550. http://europepmc.org/abstract/MED/27963035 [6] Shah MA, Stoller R, Shibata S, et al. Random assignment multicenter Phase 2 study of modified docetaxel Cisplatin, fluorouracil (mDCF) versus DCF with growth factor support (GCSF) in metastatic gastroesophageal adenocarcinoma (GE) [J]. Gastrointestinal Cancers Symposium, 2010, 46: 22-24. [7] Okines AF, Norman AR, McCloud P, et al. Meta-analysis of the REAL-2 and ML17032 trials: evaluating capecitabine-based combination chemotherapy and infused 5-fluorouracil-based combinationchemotherapy for the treatment of advanced oesophago-gastric cancer[J]. Ann Oncol, 2009, 20(9): 1529-1534. doi: 10.1093/annonc/mdp047 [8] Ma BB, Hui EP, Mok TS. Population-based differences in treatment outcome following anticancer drug therapies[J]. Lancet Oncol, 2010, 11(1): 75-84. doi: 10.1016/S1470-2045(09)70160-3 [9] 谈凯, 谢敏. 奥沙利铂联合卡培他滨在Ⅱ~Ⅲ期胃癌术后化疗中的疗效观察[J]. 中国肿瘤临床, 2011, 38(18): 1166-1168. doi: 10.3969/j.issn.1000-8179.2011.18.028 [10] Kang Y, Ohtsu A, Van Cutsem E, et al. AVAGAST: a randomized, double-blind, placebo-controlled Phase 3 study of first-line capecitabine and cisplatin plus bevacizumab or placebo in patients with advanced gastric cancer (AGC)[J]. J Clin Oncol, 2010, 28(Suppl 18): Abstract LBA4007. http://europepmc.org/abstract/MED/27937466 [11] Thuss-Patience P, Kretzschmar A, Bichev D, et al. Survival advantage for irinotecan versus best supportive care as second-line chemotherapy in gastric cancer-a randomised Phase Ⅲ study of the Arbeitsgemeinschaft Internistische Onkologie (AIO[J]. Eur J Cancer, 2011, 47(15): 2306-2314. doi: 10.1016/j.ejca.2011.06.002 [12] Park SH, Lim DH, Park K, et al. A multicenter, randomized Phase 3 trial comparing second-line chemotherapy (SLC) plus best supportive care (BSC) with BSC alone for pretreated advanced gastric cancer (AGC)[J]. J Clin Oncol, 2012, 30(13): 1513-1518. doi: 10.1200/JCO.2011.39.4585 [13] Gubanski M, Johnsson A, Fernebro E, et al. Randomized Phase 2 study of sequentialdocetaxel and irinotecan with 5-fluorouracil/folinic acid (leucovorin) in patients with advanced gastric cancer: the GATAC trial Gastric cancer taxotere vs Campto trial (GATAC)study group[J]. Gastric Cancer, 2010, 13(3): 155-161. doi: 10.1007/s10120-010-0553-4 [14] Bang Y, Chung H, Xu J, et al. Pathological features of advanced gastric cancer (GC): relationship to human epidermal growth factor receptor 2 (HER2) positivity in the global screening programme of the ToGA trial[J]. J Clin Oncol, 2009, 27(15s): Abstract 4556. [15] Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a Phase 3, open-label, randomised controlled trial[J]. Lancet, 2010, 376(9742): 687-697. doi: 10.1016/S0140-6736(10)61121-X [16] Lordick F, Luber B, Lorenzen S, el al. Cetuximab plus oxaliplatin/leucovorin/5-fluorouracil in first-line metastatic gastric cancer: a phase Ⅱ study of the Arbeitsgemeinschaft Internistische Onkologie(AIO)[J]. Br J Cancer, 2010, 102(3): 500-505. doi: 10.1038/sj.bjc.6605521 [17] Dragovich T, McCoy S, Fenoglio-Preiser CM, et al. Phase 2 trial of erlotinib in gastroesophageal junction and gastric adenocarcinomas[J]. J Clin Oncol, 2006, 24(30): 4922-4927. doi: 10.1200/JCO.2006.07.1316 [18] Sun W, Powell M, O'Dwyer PJ, et al. Phase 2 study of sorafenib in combination with docetaxel and cisplatin in the treatment of metastatic or advanced gastric and gastroesophageal junction adenocarcinoma[J]. J Clin Oncol, 2010, 28(18): 2947-2951. doi: 10.1200/JCO.2009.27.7988
点击查看大图
计量
- 文章访问数: 87
- HTML全文浏览量: 48
- PDF下载量: 4
- 被引次数: 0