晚期胃食管癌的全身治疗：进展与陷阱
Systemic therapy for advanced gastroesophageal cancers: progress and pitfalls.
作者信息
Epistola Raisa J, Chao Joseph
机构信息
Department of Internal Medicine, Harbor UCLA Medical Center, Torrance, CA, USA.
Department of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
出版信息
Transl Gastroenterol Hepatol. 2020 Oct 5;5:53. doi: 10.21037/tgh.2020.01.10. eCollection 2020.
Abstract
Advanced gastroesophageal cancer in which surgical resection is no longer appropriate is an aggressive malignancy with poor prognosis. This review provides an overview of the key trials that have led to the current standard of care, both highlighting progress with systemic cytotoxic and biological therapies, but also calling attention to pitfalls to assist practitioners in optimizing currently available treatments for their patients. This review surveys recent and ongoing trials and biomarker studies regarding the use of anti-HER2 agents, with increased recognition of molecular intratumoral heterogeneity confounding such targeted therapy strategies. We conclude with an overview of recent major trials incorporating immune checkpoint inhibitors among patients with metastatic and locally advanced gastroesophageal cancer and providing a framework for the discriminate application of these new therapies.
摘要
手术切除不再适用的晚期胃食管癌是一种侵袭性恶性肿瘤，预后较差。本综述概述了促成当前治疗标准的关键试验，既强调了全身细胞毒性和生物疗法的进展，也提醒注意一些陷阱，以帮助从业者为患者优化现有治疗方案。本综述调查了关于使用抗HER2药物的近期和正在进行的试验以及生物标志物研究，同时越来越认识到肿瘤内分子异质性会混淆此类靶向治疗策略。我们最后概述了近期在转移性和局部晚期胃食管癌患者中纳入免疫检查点抑制剂的主要试验，并为这些新疗法的区别应用提供了一个框架。
相似文献
1
Systemic therapy for advanced gastroesophageal cancers: progress and pitfalls.晚期胃食管癌的全身治疗：进展与陷阱
Transl Gastroenterol Hepatol. 2020 Oct 5;5:53. doi: 10.21037/tgh.2020.01.10. eCollection 2020.
2
Role of Checkpoint Inhibitors in the Management of Gastroesophageal Cancers.检查点抑制剂在食管癌和胃癌治疗中的作用。
Cancers (Basel). 2023 Aug 14;15(16):4099. doi: 10.3390/cancers15164099.
3
Perioperative immune checkpoint inhibitor therapy for gastric and gastroesophageal junction cancers: a review of current approaches and future perspectives.胃和胃食管交界处癌症的围手术期免疫检查点抑制剂治疗：当前方法和未来展望的综述。
Int J Clin Oncol. 2023 Nov;28(11):1431-1441. doi: 10.1007/s10147-023-02388-w. Epub 2023 Jul 28.
4
Immune Checkpoint Inhibitors in Locally Advanced, Unresectable, and Metastatic Upper Gastrointestinal Malignancies.免疫检查点抑制剂在局部晚期、不可切除和转移性上消化道恶性肿瘤中的应用。
J Gastrointest Cancer. 2020 Jun;51(2):611-619. doi: 10.1007/s12029-019-00243-8.
5
Targeting the PD-1 pathway: a new hope for gastrointestinal cancers.靶向PD-1通路：胃肠道癌症的新希望。
Curr Med Res Opin. 2017 Apr;33(4):749-759. doi: 10.1080/03007995.2017.1279132. Epub 2017 Jan 31.
6
Targeted therapies for gastroesophageal cancers.胃食管癌的靶向治疗
Ann Transl Med. 2020 Sep;8(17):1104. doi: 10.21037/atm-20-3265.
7
Immune checkpoint inhibitors for treatment of advanced gastric or gastroesophageal junction cancer: Current evidence and future perspectives.用于治疗晚期胃癌或胃食管交界癌的免疫检查点抑制剂：当前证据与未来展望
Chin J Cancer Res. 2020 Jun;32(3):287-302. doi: 10.21147/j.issn.1000-9604.2020.03.02.
8
Therapeutic Advances in the Treatment of Gastroesophageal Cancers.胃肠癌治疗的治疗进展。
Biomolecules. 2023 May 6;13(5):796. doi: 10.3390/biom13050796.
9
The integration of immune checkpoint inhibitors with VEGF targeted agents in advanced gastric and gastroesophageal adenocarcinoma: a review on the rationale and results of early phase trials.免疫检查点抑制剂与 VEGF 靶向药物联合用于晚期胃和胃食管腺癌：早期临床试验的原理和结果综述。
J Hematol Oncol. 2021 Jan 12;14(1):13. doi: 10.1186/s13045-021-01034-0.
10
HER2-targeted advanced metastatic gastric/gastroesophageal junction adenocarcinoma: treatment landscape and future perspectives.人表皮生长因子受体2靶向的晚期转移性胃/胃食管交界腺癌：治疗现状与未来展望
Biomark Res. 2022 Sep 30;10(1):71. doi: 10.1186/s40364-022-00416-x.
引用本文的文献
1
Salvage Chemoradiotherapy for Loco-Regional Recurrence of Esophageal Squamous Cell Carcinoma After Esophagectomy.食管癌切除术后局部区域复发的挽救性放化疗用于食管鳞状细胞癌
J Clin Med. 2025 Feb 25;14(5):1540. doi: 10.3390/jcm14051540.
2
Gastric adenocarcinoma: 1-year overall survival, disability-adjusted life years, years of life lost, and prognostic factors-a single-institution experience.胃腺癌：1年总生存率、伤残调整生命年、寿命损失年及预后因素——单机构经验
Front Oncol. 2022 Sep 8;12:918833. doi: 10.3389/fonc.2022.918833. eCollection 2022.
3
Efficacy and tolerability of fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) in unselected patients with advanced gastric and gastroesophageal cancer: does age really matter?氟尿嘧啶、亚叶酸钙、奥沙利铂和多西他赛（FLOT）方案在未经筛选的晚期胃癌和胃食管癌患者中的疗效及耐受性：年龄真的有影响吗？
J Cancer Res Clin Oncol. 2023 May;149(5):1849-1862. doi: 10.1007/s00432-022-04109-8. Epub 2022 Jun 28.
4
MiR-223 Promotes Tumor Progression via Targeting RhoB in Gastric Cancer.微小RNA-223通过靶向RhoB促进胃癌肿瘤进展。
J Oncol. 2022 Jan 6;2022:6708871. doi: 10.1155/2022/6708871. eCollection 2022.
5
Efficacy of systemic oncological treatments in patients with advanced esophageal or gastric cancers at high risk of dying in the middle and short term: an overview of systematic reviews.中短期死亡风险较高的晚期食管或胃腺癌患者全身肿瘤治疗效果的系统评价概述。
BMC Cancer. 2021 Jun 16;21(1):712. doi: 10.1186/s12885-021-08330-5.
6
Progressive Sarcopenia Correlates with Poor Response and Outcome to Immune Checkpoint Inhibitor Therapy.进行性肌肉减少症与免疫检查点抑制剂治疗的不良反应及预后相关。
J Clin Med. 2021 Mar 25;10(7):1361. doi: 10.3390/jcm10071361.
本文引用的文献
1
Randomized Phase III KEYNOTE-181 Study of Pembrolizumab Versus Chemotherapy in Advanced Esophageal Cancer.帕博利珠单抗对比化疗用于晚期食管癌的随机 III 期 KEYNOTE-181 研究。
J Clin Oncol. 2020 Dec 10;38(35):4138-4148. doi: 10.1200/JCO.20.01888. Epub 2020 Oct 7.
2
Nivolumab versus chemotherapy in patients with advanced oesophageal squamous cell carcinoma refractory or intolerant to previous chemotherapy (ATTRACTION-3): a multicentre, randomised, open-label, phase 3 trial.纳武利尤单抗对比化疗用于既往化疗后进展或不耐受的晚期食管鳞癌患者（ATTRACTION-3）：一项多中心、随机、开放标签、III 期临床研究。
Lancet Oncol. 2019 Nov;20(11):1506-1517. doi: 10.1016/S1470-2045(19)30626-6. Epub 2019 Sep 30.
3
Esophageal and Esophagogastric Junction Cancers, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology.食管和胃食管交界处癌，2019 年第 2 版，NCCN 肿瘤学临床实践指南。
J Natl Compr Canc Netw. 2019 Jul 1;17(7):855-883. doi: 10.6004/jnccn.2019.0033.
4
Ramucirumab and paclitaxel in patients with gastric cancer and prior trastuzumab: subgroup analysis from RAINBOW study.RAINBOW 研究中曲妥珠单抗治疗后的胃癌患者使用雷莫芦单抗联合紫杉醇的亚组分析。
Future Oncol. 2019 Aug;15(23):2723-2731. doi: 10.2217/fon-2019-0243. Epub 2019 Jun 25.
5
Docetaxel plus cisplatin and S-1 versus cisplatin and S-1 in patients with advanced gastric cancer (JCOG1013): an open-label, phase 3, randomised controlled trial.多西他赛联合顺铂和 S-1 对比顺铂和 S-1 一线治疗晚期胃癌的疗效（JCOG1013）：一项开放标签、三期、随机对照临床试验。
Lancet Gastroenterol Hepatol. 2019 Jul;4(7):501-510. doi: 10.1016/S2468-1253(19)30083-4. Epub 2019 May 14.
6
Progress and challenges in HER2-positive gastroesophageal adenocarcinoma.人表皮生长因子受体 2 阳性胃食管腺癌的进展与挑战。
J Hematol Oncol. 2019 May 17;12(1):50. doi: 10.1186/s13045-019-0737-2.
7
Biomarker analysis of the GATSBY study of trastuzumab emtansine versus a taxane in previously treated HER2-positive advanced gastric/gastroesophageal junction cancer.曲妥珠单抗-美坦新偶联物对比紫杉类药物治疗既往接受过治疗的人表皮生长因子受体 2（HER2）阳性晚期胃/胃食管结合部腺癌的 GATSBY 研究的生物标志物分析。
Gastric Cancer. 2019 Jul;22(4):803-816. doi: 10.1007/s10120-018-00923-7. Epub 2019 Jan 31.
8
Targeted literature review of the global burden of gastric cancer.全球胃癌负担的针对性文献综述。
Ecancermedicalscience. 2018 Nov 26;12:883. doi: 10.3332/ecancer.2018.883. eCollection 2018.
9
Cancer statistics, 2019.癌症统计数据，2019 年。
CA Cancer J Clin. 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. Epub 2019 Jan 8.
10
Re-evaluation of HER2 status in patients with HER2-positive advanced or recurrent gastric cancer refractory to trastuzumab (KSCC1604).曲妥珠单抗耐药的 HER2 阳性晚期或复发性胃癌患者中 HER2 状态的再评估（KSCC1604）。
Eur J Cancer. 2018 Dec;105:41-49. doi: 10.1016/j.ejca.2018.09.024. Epub 2018 Nov 2.
Zotero 插件