Mawalla Brian, Yuan Xianglin, Luo Xiaoxiao, Chalya Phillip L
Department of Oncology, Huazhong University of Science and Technology, Tongji Medical College, Tongji Hospital, Wuhan, Hubei, China.
Department of Surgery, Bugando Medical Centre, Mwanza, Tanzania.
BMC Res Notes. 2018 Jan 12;11(1):21. doi: 10.1186/s13104-018-3137-8.
Advanced gastric cancer poses a therapeutic challenge worldwide. In randomised clinical trials, anti-VEGF has been reported as an essential agent for the treatment of advanced gastric cancer. This review aims at assessing the treatment outcome of anti-angiogenesis therapy through the VEGF pathway in the management of patients with advanced gastric cancer.
During this review, 38 clinical trials were identified. Of these, 30 clinical trials were excluded, leaving eight trials of phase II and III. Ramucirumab, as a second line treatment of advanced gastric cancer, decreases the risk of disease progression (37-52%) and death (19-22%). Compare ramucirumab and bevacizumab in combination with traditional chemotherapy; ramucirumab has shown to improve progression-free survival and overall survival. Apatinib tyrosine kinase inhibitor combined with traditional chemotherapy has shown to improve overall response rate and progression-free survival with marginal improvements in overall survival. Chemotherapy, in combination with anti-VEGF drugs, in the management of advanced gastric cancer significantly improves the outcome of overall response rate, progression-free survival and overall survival when compared to chemotherapy alone. Therefore, we recommend that anti-VEGF drugs are the drugs of choice in the management of patients with advanced gastric cancer.
晚期胃癌在全球范围内都构成了治疗挑战。在随机临床试验中，抗血管内皮生长因子（VEGF）已被报道为治疗晚期胃癌的重要药物。本综述旨在评估通过VEGF途径进行抗血管生成治疗在晚期胃癌患者管理中的治疗效果。
在本次综述过程中，共识别出38项临床试验。其中，30项临床试验被排除，最终留下8项II期和III期试验。雷莫西尤单抗作为晚期胃癌的二线治疗药物，可降低疾病进展风险（37%-52%）和死亡风险（19%-22%）。将雷莫西尤单抗与贝伐单抗联合传统化疗进行比较；雷莫西尤单抗已显示出可改善无进展生存期和总生存期。阿帕替尼酪氨酸激酶抑制剂联合传统化疗已显示出可提高总体缓解率和无进展生存期，总生存期有轻微改善。与单纯化疗相比，化疗联合抗VEGF药物治疗晚期胃癌可显著改善总体缓解率、无进展生存期和总生存期的治疗效果。因此，我们建议抗VEGF药物是晚期胃癌患者管理中的首选药物。
