Raimondi Alessandra, Nichetti Federico, Peverelli Giorgia, Di Bartolomeo Maria, De Braud Filippo, Pietrantonio Filippo
Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Department of Oncology & Hemato-oncology, University of Milan, Italy.
Pharmacogenomics. 2018 Aug 1;19(13):1047-1068. doi: 10.2217/pgs-2018-0077. Epub 2018 Jul 25.
Gastric cancer is a highly heterogeneous disease, displaying a complex genomic landscape and an unfavorable outcome with standard therapies. Based on distinctive genomic alterations, novel targeted agents have been developed with the aim of personalizing treatments and improving patient outcome. However, a subgroup of patients is primarily treatment-resistant, and even in the initially sensitive population, secondary resistance emerges, thus limiting therapeutic benefit. In this review, we summarize the clinical data about standard targeted agents in gastric cancer, specifically anti-HER2 treatments and antivascular therapies. We also illustrate the available evidence regarding molecular mechanisms of resistance to these agents and we discuss potential strategies for new targeted treatments that could overcome such resistance.
胃癌是一种高度异质性的疾病，具有复杂的基因组格局，采用标准疗法治疗效果不佳。基于独特的基因组改变，已开发出新型靶向药物，旨在实现个性化治疗并改善患者预后。然而，有一部分患者主要存在治疗抵抗性，甚至在初始敏感人群中也会出现继发性耐药，从而限制了治疗益处。在本综述中，我们总结了关于胃癌标准靶向药物的临床数据，特别是抗HER2治疗和抗血管生成治疗。我们还阐述了有关对这些药物耐药的分子机制的现有证据，并讨论了可能克服这种耐药性的新靶向治疗的潜在策略。
