Yazici Ozan, Sendur M Ali Nahit, Ozdemir Nuriye, Aksoy Sercan
Ozan Yazici, Nuriye Ozdemir, Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara 06100, Turkey.
World J Gastroenterol. 2016 Jan 14;22(2):471-89. doi: 10.3748/wjg.v22.i2.471.
Advanced gastric cancer (AGC) is associated with a high mortality rate and, despite multiple new chemotherapy options, the survival rates of patients with AGC remains poor. After the discovery of targeted therapies, research has focused on the new treatment options for AGC. In the last two decades, many targeted molecules were developed against AGC. Currently, two targeted therapy molecules have been approved for patients with AGC. In 2010, trastuzumab was the first molecule shown to improve survival in patients with HER2-positive AGC as part of a first-line combination regimen. In 2014, ramucirumab was the second targeted molecule to improve survival rates and was suggested as treatment for patients with AGC who had progressed after first-line platinum plus fluoropyrimidine with or without anthracycline chemotherapy. Ramucirumab was the first targeted therapy acting as a single agent in patients with advanced gastroesophageal cancers. Although these two molecules were introduced into clinical use, many other promising molecules have been tested in phase I-II trials. It is obvious that in the near future many different targeted therapies will be in use for treatment of AGC. In this review, the current status of targeted therapies in the treatment of AGC and gastroesophageal junction tumors, including HER (2-3) inhibitors, epidermal growth factor receptor inhibitors, tyrosine kinase inhibitors, antiangiogenic agents, c-MET inhibitors, mammalian target of rapamycin inhibitors, agents against other molecular pathways fibroblast growth factor, Claudins, insulin-like growth factor, heat shock proteins, and immunotherapy, will be discussed.
晚期胃癌（AGC）的死亡率很高，尽管有多种新的化疗方案，但AGC患者的生存率仍然很低。在发现靶向治疗后，研究重点转向了AGC的新治疗选择。在过去的二十年里，针对AGC开发了许多靶向分子。目前，已有两种靶向治疗分子被批准用于AGC患者。2010年，曲妥珠单抗作为一线联合治疗方案的一部分，是首个被证明可提高HER2阳性AGC患者生存率的分子。2014年，雷莫西尤单抗是第二个能提高生存率的靶向分子，被建议用于一线铂类加氟嘧啶化疗（含或不含蒽环类化疗）后病情进展的AGC患者。雷莫西尤单抗是首个在晚期胃食管癌患者中作为单药使用的靶向治疗药物。尽管这两种分子已投入临床使用，但许多其他有前景的分子已在I-II期试验中进行了测试。很明显，在不久的将来，许多不同的靶向治疗将用于AGC的治疗。在这篇综述中，将讨论AGC和胃食管交界肿瘤靶向治疗的现状，包括HER（2-3）抑制剂、表皮生长因子受体抑制剂、酪氨酸激酶抑制剂、抗血管生成药物、c-MET抑制剂、雷帕霉素哺乳动物靶点抑制剂、针对其他分子途径的药物（成纤维细胞生长因子、Claudins、胰岛素样生长因子、热休克蛋白）以及免疫治疗。
