Tarazona Noelia, Gambardella Valentina, Huerta Marisol, Roselló Susana, Cervantes Andrés
Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain.
Rio Hortega Contract CM15/00246, Valencia, Spain.
Curr Oncol Rep. 2016 Jul;18(7):41. doi: 10.1007/s11912-016-0525-x.
Despite recent diagnostic and therapeutic advances, the survival of patients with gastric cancer is still poor. The majority of patients are diagnosed with advanced disease and chemotherapy represents the only possible therapeutic approach. However, chemotherapy seems to have reached an efficacy plateau in this setting. Gastric cancer is a complex and heterogeneous disease because it emerges from multiple interactions of genetic, environmental and host factors. A better understanding of its molecular characteristics may lead to an improvement of outcomes. The recent molecular classification by The Cancer Genome Atlas project divides gastric cancer into four subtypes that could be taken into consideration in future clinical trials with targeted agents. So far trastuzumab, a monoclonal antibody addressing the HER2 receptor, is the only targeted agent approved in the first-line setting, but only in patients overexpressing HER2. Negative data have been obtained in first-line therapy when antiangiogenics, anti-EGFR or anti-MET monoclonal antibodies have been studied in randomised controlled trials. Ramucirumab, a monoclonal antibody binding to VEGFR2, is the only antiangiogenic agent currently recommended in patients progressing after first-line treatment. In this review, we discuss whether personalised therapy may have a role in gastric cancer.
尽管近期在诊断和治疗方面取得了进展，但胃癌患者的生存率仍然很低。大多数患者被诊断为晚期疾病，化疗是唯一可能的治疗方法。然而，在这种情况下化疗似乎已达到疗效平台期。胃癌是一种复杂的异质性疾病，因为它源于遗传、环境和宿主因素的多种相互作用。更好地了解其分子特征可能会改善治疗结果。癌症基因组图谱（The Cancer Genome Atlas）项目最近的分子分类将胃癌分为四种亚型，这在未来使用靶向药物的临床试验中可能会被考虑。到目前为止，针对HER2受体的单克隆抗体曲妥珠单抗是一线治疗中唯一获批的靶向药物，但仅适用于HER2过表达的患者。在一线治疗中，当在随机对照试验中研究抗血管生成药、抗表皮生长因子受体（EGFR）或抗间质-上皮转化因子（MET）单克隆抗体时，得到的都是阴性数据。雷莫西尤单抗是一种与血管内皮生长因子受体2（VEGFR2）结合的单克隆抗体，是目前唯一推荐用于一线治疗后病情进展患者的抗血管生成药物。在这篇综述中，我们讨论了个性化治疗在胃癌中是否可能发挥作用。
