转移性或局部晚期胃癌的二线治疗选择

Second-line treatment for metastatic or locally advanced gastric cancer

胃癌是恶性肿瘤相关死亡的主要原因之一。在临床实践中，许多转移性胃癌患者一线化疗进展后接受了挽救化疗，这种化疗或靶向治疗作为二线治疗能够延长患者的总生存时间。ramucirumab单药和ramucirumab联合紫杉醇已被美国食品药品监督管理局批准，用于治疗既往化疗失败的晚期胃癌或胃食管交界腺癌。紫杉醇、伊立替康或多西他赛单药治疗也被推荐为优选化疗方案。文章将总结转移性或局部晚期胃癌的二线治疗选择。

Gastric cancer is one of the major causes of cancer-related deaths. Many patients with metastatic gastric cancer after first-line chemotherapy received salvage chemotherapy in routine clinical practice. Recent phase Ⅲ trials demonstrated substantial prolongation of overall survival to support this chemotherapy or targeted therapy as a second-line treatment. Both ramucirumab monotherapy and ramucirumab plus paclitaxel were approved by FDA in patients with previously treated advanced gastric or gastroesophageal junction adenocarcinoma. In addition, paclitaxel, irinotecan, or docetaxel monotherapy is also recommended for preferred regimens. This review will summarize chemotherapy or targeted therapy as a second-line treatment in advanced gastric cancer.