晚期胃癌治疗的研究现状与展望

Current status and prospect of treatment of advanced gastric cancer

目的 了解晚期胃癌最新治疗的研究进展,以寻求晚期胃癌患者的最佳治疗策略。方法 检索近年来国内外关于晚期胃癌治疗策略研究的文献并进行综述。结果 对于晚期胃癌患者,化学药物治疗、放射治疗、靶向药物治疗、免疫药物治疗、姑息性治疗、营养支持及中医药治疗目前在临床均有使用,多采用联合治疗。新型化学药物或抗体偶联药物的出现,以及免疫或靶向药物治疗进入一线治疗时代,免疫单药、免疫联合化学药物、双免药物联合及免疫药物联合抗血管生成靶向药物在晚期胃癌中展示出了一定的生存获益。结论 新型抗肿瘤药物的研究开发和应用,使晚期胃癌的治疗手段得到了不断拓展。以分子分型为导向的精准诊断和治疗格局正逐渐走向成熟。然而晚期胃癌的治疗依旧面临挑战,精准医学时代,面临着胃癌的高度异质性、药物精准治疗的困境和新型抗肿瘤药物的研发,晚期胃癌的最佳治疗模式仍需进一步探索,需结合患者身体状况、既往治疗情况、药物可及性等众多方面综合考量。

Objective To understand the latest research progress in the treatment of advanced gastric cancer(AGC)and explore the optimal treatment strategy.Method The latest literature on the treatment of AGC was retrieved and reviewed.Results For patients with AGC,chemotherapy,radiotherapy,targeted therapy,immunotherapy,palliative therapy,nutritional support,and traditional Chinese medicine therapy were currently adopted in clinic,the combination of them were used usually.Some patients obtained good therapeutic effects by new chemotherapy drugs and antibody conjugated drugs.In the era of first-line immunotherapy or targeted therapy,first-line immunotherapy alone,immunotherapy in combination with chemotherapy,double immunotherapy,and immunotherapy combined with antiangiogenesis targeted drugs for AGC had represented some survival benefits.Conclusions The research,development,and widespread application of new anti-tumor drugs have continuously expanded the treatment methods for AGC.The development of tumor molecular biology provides an opportunity for the treatment of AGC,and the precise diagnosis and treatment pattern guided by molecular typing is gradually maturing.However,the treatment of AGC is still facing challenges.In the era of precision medicine,facing the higher heterogeneity of gastric cancer,the dilemma of precise treatment of drugs for AGC,and the research and development of new anti-tumor drugs,the optimal treatment mode of AGC still needs more clinical exploration.It is necessary to comprehensively consider various aspects such as the patient’s physical condition,previous treatment status,and drug accessibility.