Division of Medical Oncology and Hematology, Loma Linda University, Loma Linda, CA 92354, USA.
J Hematol Oncol. 2010 Mar 23;3:11. doi: 10.1186/1756-8722-3-11.
We have reviewed the pivotal presentations related to gastrointestinal malignancies from 2009 annual meeting of the American Society of Clinical Oncology with the theme of "personalizing cancer care". We have discussed the scientific findings and the impact on practice guidelines and ongoing clinical trials. Adding trastuzumab to chemotherapy improved the survival of patients with advanced gastric cancer overexpressing human epidermal growth factor receptor 2. Gemcitabine plus cisplatin has become a new standard for first-line treatment of advanced biliary cancer. Octreotide LAR significantly lengthened median time to tumor progression compared with placebo in patients with metastatic neuroendocrine tumors of the midgut. Addition of oxaliplatin to fluoropyrimidines for preoperative chemoradiotherapy in patients with stage II or III rectal cancer did not improve local tumor response but increased toxicities. Bevacizumab did not provide additional benefit to chemotherapy in adjuvant chemotherapy for stage II or III colon cancer. In patients with resected stage II colon cancer, recurrence score estimated by multigene RT-PCR assay has been shown to provide additional risk stratification. In stage IV colorectal cancer, data have supported the routine use of prophylactic skin treatment in patients receiving antibody against epidermal growth factor receptor, and the use of upfront chemotherapy as initial management in patients with synchronous metastasis without obstruction or bleeding from the primary site.
我们回顾了以“个性化癌症护理”为主题的 2009 年美国临床肿瘤学会年会中与胃肠道恶性肿瘤相关的关键演讲。我们讨论了科学发现及其对实践指南和正在进行的临床试验的影响。曲妥珠单抗联合化疗可提高人表皮生长因子受体 2 过表达的晚期胃癌患者的生存率。吉西他滨加顺铂已成为晚期胆管癌一线治疗的新标准。奥曲肽长效注射剂与安慰剂相比，可显著延长中肠转移性神经内分泌肿瘤患者的中位疾病进展时间。奥沙利铂联合氟嘧啶用于 II 期或 III 期直肠癌术前放化疗并不能改善局部肿瘤反应，但增加了毒性。贝伐单抗在 II 期或 III 期结肠癌的辅助化疗中并未为化疗提供额外益处。在 II 期结肠癌切除的患者中，多基因 RT-PCR 检测估计的复发评分已被证明可提供额外的风险分层。在 IV 期结直肠癌中，数据支持对接受表皮生长因子受体抗体治疗的患者常规进行预防性皮肤治疗，以及对无梗阻或原发部位出血的同步转移患者采用初始治疗作为初始治疗。
