晚期胃癌中少见靶点的特征与治疗进展

Characteristics and therapeutic progress of rare targets in advanced gastric cancer

胃癌是我国常见的消化系统恶性肿瘤,其恶性程度高,发现时又多处于晚期,大部分患者失去根治性手术机会,导致胃癌患者生存时间有限。目前越来越多的证据证明靶向治疗在改善胃癌患者预后中起到了一定作用,是进一步改善预后的选择,探索更多的靶点至关重要。针对EB病毒(EBV)相关性胃癌、成纤维生长因子(FGFR)阳性及微卫星不稳定胃癌的临床特征、分子机制以及预后进行研究发现,这类患者相较于普通胃癌不仅具有独特的临床表现,同时还是潜在的生物标志物及治疗靶点,有望进一步延长胃癌患者的生存时间;临床研究还发现这些靶点与免疫治疗疗效相关。本文针对这些靶点进行综述,以增加对少见靶点胃癌人群的认识及提升靶向药物开发的效率。

Gastric cancer is a common malignant tumor of the digestive system,with a high degree of malignancy and a late stage of discovery.Most patients lose the chance of radical surgery,and their median survival time is limited.At present,more and more evidences prove that targeted therapy plays a great role in improving the prognosis of patients with gastric cancer,and it is the choice to further improve the prognosis.It is crucial to explore more targets.The clinical features,molecular mechanism and prognosis of EBV associated gastric cancer,fibroblast growth factor(FGFR)positive and microsatellite instability gastric cancer were studied.It was found that these patients not only have unique clinical manifestations,but also are potential biomarkers and therapeutic targets,which is expected to further prolong the survival time of gastric cancer patients.Clinical studies have also found that these targets are related to the efficacy of immunotherapy.In this paper,we review these targets in order to improve the understanding of gastric cancer patients with rare targets and the efficiency of targeted drug development.