Maeda Osamu, Ando Yuichi
Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya 466-8560, Japan.
World J Gastrointest Oncol. 2019 Jul 15;11(7):518-526. doi: 10.4251/wjgo.v11.i7.518.
Key cytotoxic drugs of chemotherapy for gastroesophageal cancer include fluoropyrimidine, platinum, taxanes and irinotecan. Concurrent chemoradiotherapy is one of the main treatment strategies, especially for esophageal cancer. As molecular target agents, the anti-HER2 antibody trastuzumab for HER2-positive gastric cancer and the anti-angiogenesis agent ramucirumab combined with paclitaxel have been proven to improve the survival of gastric cancer patients. Recently, anti-PD-1 antibodies have become available as second- or later-line chemotherapy. Microsatellite instability is also useful as a biomarker to select patients suitable for immunotherapy. Furthermore, genome-wide analysis has improved our understanding of the biological features and molecular mechanisms of gastroesophageal cancer and will provide optimized treatment selection.
食管癌化疗的关键细胞毒性药物包括氟嘧啶、铂类、紫杉烷类和伊立替康。同步放化疗是主要治疗策略之一，尤其是对于食管癌。作为分子靶向药物，抗HER2抗体曲妥珠单抗用于HER2阳性胃癌，抗血管生成药物雷莫西尤单抗联合紫杉醇已被证明可提高胃癌患者的生存率。最近，抗PD-1抗体已作为二线或更后线化疗药物可用。微卫星不稳定性也可作为一种生物标志物，用于选择适合免疫治疗的患者。此外，全基因组分析提高了我们对食管癌生物学特征和分子机制的认识，并将提供优化的治疗选择。
