Aoyagi Keishiro, Kouhuji Kikuo, Kizaki Junya, Isobe Taro, Hashimoto Kousuke, Shirouzu Kazuo
Keishiro Aoyagi, Kikuo Kouhuji, Junya Kizaki, Taro Isobe, Kousuke Hashimoto, Kazuo Shirouzu, Department of Surgery, Kurume University School of Medicine, Fukuoka 830-0011, Japan.
World J Gastroenterol. 2014 Oct 14;20(38):13741-55. doi: 10.3748/wjg.v20.i38.13741.
Trastuzumab that targets human epidermal growth factor receptor 2 (HER2) protein is the only approved molecular targeting agent for treating gastric cancer in Japan and the outcomes have been favorable. However, trastuzumab is effective for only 10% to 20% of the population with gastric cancer that expresses HER2 protein. Molecular targeting therapy with bevacizumab against vascular endothelial growth factors (VEGF) and with cetuximab and panitumumab against the epidermal growth factors pathway that have been approved for treating colorectal cancer are not considered effective for treating gastric cancer according to several clinical trials. However, ramucirumab that targets VEGF receptor-2 prolonged overall survival in a large phase III clinical trial and it might be an effective molecular targeting therapy for gastric cancer. The significance of molecular targeting therapy for gastric cancer remains controversial. A large-scale randomized clinical trial of novel molecular targeting agents with which to treat gastric cancer is needed.
针对人表皮生长因子受体2（HER2）蛋白的曲妥珠单抗是日本唯一获批用于治疗胃癌的分子靶向药物，且治疗效果良好。然而，曲妥珠单抗仅对10%至20%表达HER2蛋白的胃癌患者有效。根据多项临床试验，针对血管内皮生长因子（VEGF）的贝伐单抗以及针对表皮生长因子途径的西妥昔单抗和帕尼单抗等已获批用于治疗结直肠癌的分子靶向治疗，对胃癌治疗无效。然而，靶向VEGF受体-2的雷莫西尤单抗在一项大型III期临床试验中延长了总生存期，可能是一种有效的胃癌分子靶向治疗方法。胃癌分子靶向治疗的意义仍存在争议。需要开展一项关于新型分子靶向药物治疗胃癌的大规模随机临床试验。
