Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, 510060, People's Republic of China.
J Hematol Oncol. 2023 May 27;16(1):57. doi: 10.1186/s13045-023-01451-3.
Gastric cancer (GC) is one of the most common malignancies worldwide. Most patients are diagnosed at advanced stages due to the subtle symptoms of earlier disease and the low rate of regular screening. Systemic therapies for GC, including chemotherapy, targeted therapy and immunotherapy, have evolved significantly in the past few years. For resectable GC, perioperative chemotherapy has become the standard treatment. Ongoing investigations are exploring the potential benefits of targeted therapy or immunotherapy in the perioperative or adjuvant setting. For metastatic disease, there have been notable advancements in immunotherapy and biomarker-directed therapies recently. Classification based on molecular biomarkers, such as programmed cell death ligand 1 (PD-L1), microsatellite instability (MSI), and human epidermal growth factor receptor 2 (HER2), provides an opportunity to differentiate patients who may benefit from immunotherapy or targeted therapy. Molecular diagnostic techniques have facilitated the characterization of GC genetic profiles and the identification of new potential molecular targets. This review systematically summarizes the main research progress in systemic treatment for GC, discusses current individualized strategies and presents future perspectives.
胃癌(GC)是全球最常见的恶性肿瘤之一。由于早期疾病症状不明显且常规筛查率低,大多数患者在晚期才被诊断出来。过去几年,GC 的全身治疗方法,包括化疗、靶向治疗和免疫治疗,已经有了显著的发展。对于可切除的 GC,围手术期化疗已成为标准治疗。目前正在进行的研究探索了靶向治疗或免疫治疗在围手术期或辅助治疗中的潜在益处。对于转移性疾病,最近在免疫治疗和生物标志物导向治疗方面取得了显著进展。基于分子生物标志物(如程序性死亡配体 1(PD-L1)、微卫星不稳定性(MSI)和人表皮生长因子受体 2(HER2))的分类为可能受益于免疫治疗或靶向治疗的患者提供了机会。分子诊断技术促进了 GC 遗传特征的描述和新的潜在分子靶标的鉴定。本文系统总结了 GC 全身治疗的主要研究进展,讨论了当前的个体化策略,并提出了未来的展望。