胃癌靶向治疗的研究进展

The rugged road to targeted therapy for gastric cancer

胃癌是全球第2大肿瘤死因,多数患者就诊时已属晚期,预后差.化疗药物联合分子靶向药物日益成为晚期胃癌的主要治疗方法和研究热点.很多靶向药物已用于临床研究,包括血管生成抑制剂、表皮生长因子抑制剂、肝细胞生长因子抑制剂、细胞周期调节剂、金属蛋白酶抑制剂.但多数Ⅲ期临床研究结果令人失望,主要原因是入组人群未经特异性分子靶点的筛选.本文主要综述近年来胃癌靶向药物治疗的Ⅱ/Ⅲ期临床研究,评价药物的有效性及安全性,探索晚期胃癌靶向治疗的崎岖之路.

Gastric cancer is the second leading cause of can- cer related-death. Most patients with gastric can- cer present with an advanced stage of the disease that has a poor prognosis. Molecularly targeted drugs combined with chemotherapy have been becoming the main treatment for advanced gas- tric cancer. A number of targeted agents modu- lating different signal transduction pathways are currently entering clinical trials, such as angio- genesis inhibitors and agents targeting epidermal growth factor receptor, hepatocyte growth factor, cell cycle, or matrix metalloproteinases. How- ever, disappointing results were achieved in most phase II1 clinical trials, in which special patient selection by molecular biomarkers was not con- ducted. This systematic review synthesizes most of the data available from clinical trials, evaluates the efficacy and safety of molecularly targeted drugs and explores the rugged road to targeted therapy for advanced gastric cancer.