Koerner Anna S, Moy Ryan H, Ryeom Sandra W, Yoon Sam S
Division of Surgical Oncology, Department of Surgery, Columbia University Irving Medical Center, New York, NY 10032, USA.
Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Cancers (Basel). 2023 Aug 15;15(16):4114. doi: 10.3390/cancers15164114.
Gastric cancer is a highly prevalent and lethal disease worldwide. Given the insidious nature of the presenting symptoms, patients are frequently diagnosed with advanced, unresectable disease. However, many patients will present with locally advanced gastric cancer (LAGC), which is often defined as the primary tumor extending beyond the muscularis propria (cT3-T4) or having nodal metastases (cN+) disease and without distant metastases (cM0). LAGC is typically treated with surgical resection and perioperative chemotherapy. The treatment of LAGC remains a challenge, given the heterogeneity of this disease, and the optimal multimodal treatment regimen may be different for different LAGC subtypes. However, many promising treatments are on the horizon based on knowledge of molecular subtypes and key biomarkers of LAGC, such as microsatellite instability, HER2, Claudin 18.2, FGFR2, and PD-L1. This review will expand upon the discussion of current standard neoadjuvant and adjuvant therapies for LAGC and explore the ongoing and future clinical trials for novel therapies, with information obtained from searches in PubMed and ClinicalTrials.gov.
胃癌是一种在全球范围内高度流行且致命的疾病。鉴于其症状隐匿的特性，患者常常在被诊断时已处于晚期，无法进行手术切除。然而，许多患者会表现为局部晚期胃癌（LAGC），通常定义为原发肿瘤侵犯超过固有肌层（cT3 - T4）或伴有淋巴结转移（cN +）且无远处转移（cM0）的疾病。LAGC通常采用手术切除及围手术期化疗进行治疗。鉴于该疾病的异质性，LAGC的治疗仍然是一项挑战，并且针对不同的LAGC亚型，最佳的多模式治疗方案可能有所不同。然而，基于对LAGC分子亚型和关键生物标志物（如微卫星不稳定性、HER2、Claudin 18.2、FGFR2和PD - L1）的了解，许多有前景的治疗方法即将出现。本综述将详细讨论LAGC当前的标准新辅助和辅助治疗，并通过在PubMed和ClinicalTrials.gov上检索获得的信息，探索正在进行的和未来针对新型疗法的临床试验。
