晚期胃癌靶向治疗进展

Development of target therapy for advanced gastric cancer

胃癌化疗敏感性较低,存在明显的异质性,传统化疗疗效极其有限。以分子表型为指引的靶向治疗是进一步提高胃癌治疗效果的重要途径。曲妥珠单抗已被证明与化疗联合可以提高初治HER-2阳性胃癌患者的生存。相对于安慰剂,Ramuci-rumab延长了二线治疗患者的生存。抗C-MET单克隆抗体Rilotumumab在Ⅱ期研究中显示出良好的前景。然而,大多数的靶向药物都未能在胃癌的临床研究中获得成功。寻找胃癌关键的靶基因,开发更有效靶向药物仍任重道远。

The efficacy of conventional chemotherapy for gastric cancer is extremely limited because of its relatively low chemo-sensitivity and obvious heterogeneity. Molecular phenotype-directed target therapy is important for the improvement of the effi-cacy of conventional chemotherapy in treating advanced gastric cancer. Trastuzumab has been confirmed to have a survival benefit when added to chemotherapy for HER-2 positive gastric cancer. Ramucirumab can increase the survival of gastric cancer patients as second line treatment compared with a placebo. The anti-c-MET monoclonal antibody Rilotumumab indicates promising results in phaseⅡtrial. However, most of the targeting drugs in gastric cancer clinical trials have failed. Therefore, further efforts are required to explore critical targeted genes and effective agents.