Zaniboni A, Meriggi F
Fondazione Poliambulanza, Brescia, Italy.
J Chemother. 2005 Dec;17(6):656-62. doi: 10.1179/joc.2005.17.6.656.
Gastric cancer is often diagnosed in locally advanced or metastatic stages and, therefore, of poor prognosis. Many controversies exist about surgery, neoadjuvant, adjuvant and palliative treatments of gastric cancer. So we need to explore a variety of novel management options including the use of new agents and new combinations. Some of these agents include oral fluoropyrimidine, irinotecan, docetaxel and oxaliplatin. Oxaliplatin is a diaminocyclohexane-platinum compound that is significantly different from cisplatin and carboplatin with respect to its activity and toxicity. Oxaliplatin is an alkylating agent inhibiting DNA replication by forming adducts between two adjacent guanines or guanine and adenine molecules. However, the adducts of oxaliplatin appear to be more effective than cisplatin adducts in regard to the inhibition of DNA synthesis. In contrast to cisplatin, oxaliplatin has demonstrated efficacy alone and in combination with 5-fluorouracil in advanced colorectal cancer. Many studies are ongoing to test the combination in noncolorectal gastrointestinal tumors and other malignancies. This review focuses on the increasing amount of data concerning the clinical activity of oxaliplatin-based regimens in advanced gastric cancer.
胃癌往往在局部晚期或转移阶段才被诊断出来，因此预后较差。关于胃癌的手术、新辅助治疗、辅助治疗和姑息治疗存在许多争议。所以我们需要探索各种新的治疗方案，包括使用新药物和新的联合用药。其中一些药物包括口服氟嘧啶、伊立替康、多西他赛和奥沙利铂。奥沙利铂是一种二氨基环己烷铂化合物，在活性和毒性方面与顺铂和卡铂有显著差异。奥沙利铂是一种烷化剂，通过在两个相邻的鸟嘌呤之间或鸟嘌呤与腺嘌呤分子之间形成加合物来抑制DNA复制。然而，就抑制DNA合成而言，奥沙利铂的加合物似乎比顺铂加合物更有效。与顺铂不同，奥沙利铂已证明在晚期结直肠癌中单独使用以及与5-氟尿嘧啶联合使用均有效。目前正在进行许多研究来测试其在非结直肠癌胃肠道肿瘤和其他恶性肿瘤中的联合应用。这篇综述重点关注了越来越多关于以奥沙利铂为基础的方案在晚期胃癌中的临床活性的数据。
