Yuan Hui, Bao Miao, Chen Minqiang, Fu Junhao, Yu Shian
Department of Hepatobiliary and Pancreatic Surgery, Jinhua Municipal Central Hospital, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China.
The Second Ward, Department of Pediatrics, Jinhua Maternal & Child Health Hospital, Jinhua, Zhejiang, China.
Br J Hosp Med (Lond). 2025 Mar 26;86(3):1-24. doi: 10.12968/hmed.2024.0759.
Gastric cancer remains one of the most prevalent and lethal malignancies worldwide, characterized by poor survival rates, particularly in advanced stages. In recent years, a paradigm shift in gastric cancer treatment has been witnessed with the introduction of immunotherapy and targeted therapies. This review provides a detailed examination of current immunotherapeutic strategies, including adoptive cell therapy (ACT), immune checkpoint inhibitors (ICIs), and cancer vaccines. Additionally, it explores advancements in targeted therapies, focusing on the human epidermal growth factor receptor 2 (HER2) and vascular endothelial growth factor receptor (VEGFR) signaling pathways, as well as emerging targets such as claudin 18.2. Clinical trials investigating chimeric antigen receptor T-cell (CAR-T) therapy, T-cell receptor-engineered T-cell (TCR-T) therapy, and natural killer (NK) cell-based treatments have shown promise, particularly when combined with conventional chemotherapeutic regimens. However, challenges such as cytokine release syndrome, immune-related toxicities, and scalability issues remain significant. The combination of immunotherapy with targeted therapies represents a promising approach to enhance treatment outcomes. Future directions emphasize the need to overcome resistance mechanisms and refine treatment strategies to improve efficacy while reducing adverse effects. This review aims to elucidate the current landscape of immunotherapy and targeted therapy in gastric cancer and to explore their potential in shaping the future of clinical management for this devastating disease.
胃癌仍然是全球最常见且致命的恶性肿瘤之一，其生存率较低，尤其是在晚期阶段。近年来，随着免疫疗法和靶向疗法的引入，胃癌治疗发生了范式转变。本综述详细探讨了当前的免疫治疗策略，包括过继性细胞疗法（ACT）、免疫检查点抑制剂（ICI）和癌症疫苗。此外，还探讨了靶向疗法的进展，重点关注人表皮生长因子受体2（HER2）和血管内皮生长因子受体（VEGFR）信号通路，以及诸如claudin 18.2等新兴靶点。研究嵌合抗原受体T细胞（CAR-T）疗法、T细胞受体工程化T细胞（TCR-T）疗法和基于自然杀伤（NK）细胞的治疗的临床试验已显示出前景，特别是与传统化疗方案联合使用时。然而，诸如细胞因子释放综合征、免疫相关毒性和可扩展性问题等挑战仍然很严峻。免疫疗法与靶向疗法的联合是一种有望提高治疗效果的方法。未来的方向强调需要克服耐药机制并优化治疗策略，以提高疗效同时减少不良反应。本综述旨在阐明胃癌免疫疗法和靶向疗法的当前现状，并探讨它们在塑造这种毁灭性疾病临床管理未来方面的潜力。
