Department of Medicine, Royal Marsden Hospital NHS Foundation Trust, Downs Road, Sutton SM2 5PT, UK.
Br J Surg. 2013 Jan;100(1):5-14. doi: 10.1002/bjs.8987. Epub 2012 Nov 20.
The advent of affordable technologies to perform detailed molecular profiling of tumours has transformed understanding of the specific genetic events that promote carcinogenesis and which may be exploited therapeutically. The application of targeted therapeutics has led to improved outcomes in advanced disease and this approach is beginning to become established in the management of potentially curable disease for surgical patients.
This review article focuses on recent developments in the management of operable cancers of the gastrointestinal (GI) tract, specifically discussing the currently available data that evaluate the incorporation of targeted therapies in this setting.
A variety of targeted molecules are now available as treatment options in the management of GI cancers. Most are aimed at growth inhibition by acting on cell surface targets or intracellular pathways. Treatment paradigms are gradually shifting towards more prevalent use of systemic treatment prior to surgical intervention for operable disease with the aim of tumour downsizing and improved rates of long-term cure.
A large number of ongoing clinical trials are evaluating novel targeted agents as neoadjuvant therapy in operable GI tumours. Therefore, further progress in the management of early-stage disease will undoubtedly be made over the next few years as these trials continue to report potentially practice-changing results.
经济实惠的技术的出现使得对肿瘤进行详细的分子谱分析成为可能，这改变了人们对促进癌变的特定遗传事件的理解，这些事件可能具有治疗潜力。靶向治疗的应用改善了晚期疾病的治疗效果，这种方法开始在可治愈的手术患者疾病的治疗中确立地位。
本文主要讨论胃肠道（GI）可切除癌症的治疗进展，重点讨论了目前评估靶向治疗在这种情况下应用的可用数据。
目前有多种靶向分子可作为 GI 癌症治疗的选择。大多数药物通过作用于细胞表面靶点或细胞内途径来抑制生长。治疗模式逐渐向更普遍地在手术干预之前使用系统治疗转变，目的是缩小肿瘤体积并提高长期治愈的可能性。
大量正在进行的临床试验正在评估新的靶向药物作为可切除 GI 肿瘤的新辅助治疗。因此，随着这些试验继续报告潜在的改变实践的结果，未来几年早期疾病的治疗将无疑取得进一步的进展。
