Aichler Michaela, Luber Birgit, Lordick Florian, Walch Axel
Michaela Aichler, Research Unit Analytical Pathology - Institute of Pathology, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
World J Gastroenterol. 2014 Oct 14;20(38):13648-57. doi: 10.3748/wjg.v20.i38.13648.
Several new treatment options for gastric cancer have been introduced but the prognosis of patients diagnosed with gastric cancer is still poor. Disease prognosis could be improved for high-risk individuals by implementing earlier screenings. Because many patients are asymptomatic during the early stages of gastric cancer, the diagnosis is often delayed and patients present with unresectable locally advanced or metastatic disease. Cytotoxic treatment has been shown to prolong survival in general, but not all patients are responders. The application of targeted therapies and multimodal treatment has improved prognosis for those with advanced disease. However, these new therapeutic strategies do not uniformly benefit all patients. Predicting whether patients will respond to specific therapies would be of particular value and would allow for stratifying patients for personalized treatment strategies. Metabolic imaging by positron emission tomography was the first technique with the potential to predict the response of esophago-gastric cancer to neoadjuvant therapy. Exploring and validating tissue-based biomarkers are ongoing processes. In this review, we discuss the status of several targeted therapies for gastric cancer, as well as proteomic and metabolic methods for investigating biomarkers for therapy response prediction in gastric cancer.
已经引入了几种新的胃癌治疗方案，但被诊断为胃癌的患者预后仍然很差。通过实施早期筛查，高危个体的疾病预后可以得到改善。由于许多患者在胃癌早期没有症状，诊断往往会延迟，患者就诊时已出现无法切除的局部晚期或转移性疾病。细胞毒性治疗总体上已显示能延长生存期，但并非所有患者都有反应。靶向治疗和多模式治疗的应用改善了晚期患者的预后。然而，这些新的治疗策略并非对所有患者都有同样的益处。预测患者是否会对特定治疗产生反应将具有特别的价值，并能使患者分层以制定个性化的治疗策略。正电子发射断层扫描代谢成像技术是第一种有可能预测食管胃癌对新辅助治疗反应的技术。探索和验证基于组织的生物标志物是一个持续的过程。在这篇综述中，我们讨论了几种胃癌靶向治疗的现状，以及用于研究胃癌治疗反应预测生物标志物的蛋白质组学和代谢方法。
