Tan Aaron C, Chan David L, Faisal Wasek, Pavlakis Nick
Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia/National Cancer Centre Singapore, Singapore.
Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia/Northern Clinical School, University of Sydney, NSW, Australia.
Therap Adv Gastroenterol. 2018 Nov 14;11:1756284818808072. doi: 10.1177/1756284818808072. eCollection 2018.
Metastatic gastric cancer is associated with a poor prognosis and novel treatment options are desperately needed. The development of targeted therapies heralded a new era for the management of metastatic gastric cancer, however results from clinical trials of numerous targeted agents have been mixed. The advent of immune checkpoint inhibitors has yielded similar promise and results from early trials are encouraging. This review provides an overview of the systemic treatment options evaluated in metastatic gastric cancer, with a focus on recent evidence from clinical trials for targeted therapies and immune checkpoint inhibitors. The failure to identify appropriate predictive biomarkers has hampered the success of many targeted therapies in gastric cancer, and a deeper understanding of specific molecular subtypes and genomic alterations may allow for more precision in the application of novel therapies. Identifying appropriate biomarkers for patient selection is essential for future clinical trials, for the most effective use of novel agents and in combination approaches to account for growing complexity of treatment options.
转移性胃癌预后较差，亟需新的治疗方案。靶向治疗的发展开创了转移性胃癌治疗的新时代，然而，众多靶向药物的临床试验结果喜忧参半。免疫检查点抑制剂的出现也带来了类似的希望，早期试验结果令人鼓舞。本综述概述了转移性胃癌评估的全身治疗方案，重点关注靶向治疗和免疫检查点抑制剂临床试验的最新证据。未能识别合适的预测生物标志物阻碍了许多胃癌靶向治疗的成功，更深入地了解特定分子亚型和基因组改变可能会使新疗法的应用更加精准。识别合适的生物标志物以进行患者选择对于未来临床试验、最有效地使用新型药物以及应对日益复杂的联合治疗方案至关重要。
