Pericay Carles, Rivera Fernando, Gomez-Martin Carlos, Nuñez Inmaculada, Cassinello Alejo, Imedio Esteban Rodrigo
Department of Oncology, Sabadell University Hospital, Parc Tauli, Sabadell, Spain.
Department of Medical Oncology, Hospital Universitario Santander, Santander, Spain.
Cancer Med. 2016 Dec;5(12):3464-3474. doi: 10.1002/cam4.941. Epub 2016 Oct 24.
Tumors of the upper gastrointestinal tract are increasing in incidence; yet, approaches to the treatment of advanced gastric and/or gastroesophageal junction cancer vary widely, with no internationally agreed first-line regimens. Recent clinical trials have shown that second-line treatment is now possible for selected patients with advanced disease, and current data suggest that the combination of ramucirumab plus paclitaxel may become a standard of care in the second-line setting for metastatic gastric cancer. Several prognostic factors have been identified for overall survival in the second-line setting; this emphasizes the need for careful sequencing of all treatments to ensure that individual patients receive optimum care. This article reviews published data on the treatment of advanced gastric cancer, with a particular emphasis on second-line chemotherapy, and suggests treatment sequences based on current understanding.
上消化道肿瘤的发病率正在上升；然而，晚期胃癌和/或胃食管交界癌的治疗方法差异很大，尚无国际公认的一线治疗方案。最近的临床试验表明，对于部分晚期患者，二线治疗已成为可能，目前的数据表明，雷莫西尤单抗联合紫杉醇可能成为转移性胃癌二线治疗的标准疗法。已确定了二线治疗中影响总生存期的几个预后因素；这凸显了对所有治疗进行谨慎排序的必要性，以确保个体患者得到最佳治疗。本文回顾了已发表的关于晚期胃癌治疗的数据，特别强调二线化疗，并根据目前的认识提出了治疗顺序。
