Current status and prospect of treatment of advanced gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Wenzheng ,  LI Yang , LIU Guangyi

Department of Gastrointestinal and Anorectal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China;

Corresponding author：

LI Yang, Email: liyang_68813@ 126.com

Keywords：

advanced gastric cancer; immunotherapy; targeted therapy; antibody-drug conjugates

DOI：

10.7507/1007-9424.202305011

Video：

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Abstract Full text Figures/Tables Video References Cited by

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 anti-angiogenesis 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.

Citation： ZHAO Wenzheng, LI Yang, LIU Guangyi. Current status and prospect of treatment of advanced gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(8): 1015-1024. doi: 10.7507/1007-9424.202305011 Copy

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2. López MJ, Carbajal J, Alfaro AL, et al. Characteristics of gastric cancer around the world. Crit Rev Oncol Hematol, 2023, 181: 103841. doi: 10.1016/j.critrevonc.2022.103841.
3. 曹毛毛, 李贺, 孙殿钦, 等. 2000–2019年中国胃癌流行病学趋势分析. 中华消化外科杂志, 2021, 20(1): 102-109.
4. Zhang R, Li H, Li N, et al. Risk factors for gastric cancer: a large-scale, population-based case-control study. Chin Med J (Engl), 2021, 134(16): 1952-1958.
5. Eusebi LH, Telese A, Marasco G, et al. Gastric cancer prevention strategies: a global perspective. J Gastroenterol Hepatol, 2020, 35(9): 1495-1502.
6. Suzuki H, Oda I, Abe S, et al. High rate of 5-year survival among patients with early gastric cancer undergoing curative endoscopic submucosal dissection. Gastric Cancer, 2016, 19(1): 198-205.
7. 解亦斌, 田艳涛. 我国晚期胃癌临床特点及诊治策略. 中华医学杂志, 2018, 98(24): 1897-1898.
8. 季加孚, 季科. 我国胃癌外科治疗相关临床研究近10年进展及未来方向. 中国实用外科杂志, 2022, 42(10): 1081-1083, 1091.
9. Sędłak K, Rawicz-Pruszyński K, Mlak R, et al. Union is strength: textbook outcome with perioperative chemotherapy compliance decreases the risk of death in advanced gastric cancer patients. Eur J Surg Oncol, 2022, 48(2): 356-361.
10. Wang JP, Du JL, Li YY. Short-term efficacy and influencing factors of conventional chemotherapy combined with irinotecan in patients with advanced gastric cancer. World J Gastrointest Oncol, 2023, 15(1): 143-154.
11. Fuchs CS, Shitara K, Di Bartolomeo M, et al. Ramucirumab with cisplatin and fluoropyrimidine as first-line therapy in patients with metastatic gastric or junctional adenocarcinoma (RAINFALL): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol, 2019, 20(3): 420-435.
12. Que WC, Huang YF, Lin XY, et al. Paclitaxel, 5-fluorouracil, and leucovorin combination chemotherapy as first-line treatment in patients with advanced gastric cancer. Anticancer Drugs, 2019, 30(3): 302-307.
13. Zhu XD, Huang MZ, Wang YS, et al. XELOX doublet regimen versus EOX triplet regimen as first-line treatment for advanced gastric cancer: an open-labeled, multicenter, randomized, prospective phase Ⅲ trial (EXELOX). Cancer Commun (Lond), 2022, 42(4): 314-326.
14. Zhang C, Wu B, Yang H, et al. The validity of neoadjuvant chemotherapy with paclitaxel plus S-1 is not inferior to that of SOX regimen for locally advanced gastric cancer: an observational study. BMC Cancer, 2022, 22(1): 1223. doi: 10.1186/s12885-022-10230-1.
15. Chen XL, Chen XZ, Yang C, et al. Docetaxel, cisplatin and fluorouracil (DCF) regimen compared with non-taxane-containing palliative chemotherapy for gastric carcinoma: a systematic review and meta-analysis. PLoS One, 2013, 8(4): e60320. doi: 10.1371/journal.pone.0060320.
16. Wang J, Xu R, Li J, et al. Randomized multicenter phase Ⅲ study of a modified docetaxel and cisplatin plus fluorouracil regimen compared with cisplatin and fluorouracil as first-line therapy for advanced or locally recurrent gastric cancer. Gastric Cancer, 2016, 19(1): 234-244.
17. Hall PS, Swinson D, Cairns DA, et al. Efficacy of reduced-intensity chemotherapy with oxaliplatin and capecitabine on quality of life and cancer control among older and frail patients with advanced gastroesophageal cancer: The GO2 phase 3 randomized clinical trial. JAMA Oncol, 2021, 7(6): 869-977.
18. Chakrabarti S, Wintheiser G, Tella SH, et al. TAS-102: a resurrected novel fluoropyrimidine with expanding role in the treatment of gastrointestinal malignancies. Pharmacol Ther, 2021, 224: 107823.
19. Shitara K,Doi T, Dvorkin M, et al. Trifluridine/tipiracil versus placebo in patients with heavily pretreated metastatic gastric cancer (TAGS): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol, 2018, 19(11): 1437-1448.
20. Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet, 2010, 376(9742): 687-697.
21. Fong C, Chau I. HER2 inhibition in gastric cancer-novel therapeutic approaches for an established target. Cancers (Basel), 2022, 14(15): 3824. doi: 10.3390/cancers14153824.
22. 沈琳, 徐建明, 冯奉仪, 等. 曲妥珠单抗联合化疗一线治疗人表皮生长因子受体2阳性无法手术的局部进展期或转移性胃或胃食管结合部腺癌的多中心随机对照Ⅲ期临床试验中国亚组报告. 中华肿瘤杂志, 2013, 35(4): 295-300.
23. Hofheinz RD, Hegewisch-Becker S, Kunzmann V, et al. Trastuzumab in combination with 5-fluorouracil, leucovorin, oxaliplatin and docetaxel as perioperative treatment for patients with human epidermal growth factor receptor 2-positive locally advanced esophagogastric adenocarcinoma: a phase Ⅱ trial of the Arbeitsgemeinschaft Internistische Onkologie Gastric Cancer Study Group. Int J Cancer, 2021, 149(6): 1322-1331.
24. Rivera F, Romero C, Jimenez-Fonseca P, et al. Phase Ⅱ study to evaluate the efficacy of trastuzumab in combination with capecitabine and oxaliplatin in first-line treatment of HER2-positive advanced gastric cancer: HERXO trial. Cancer Chemother Pharmacol, 2019, 83(6): 1175-1181.
25. Kagawa S, Muraoka A, Kambara T, et al. A multi-institution phase Ⅱ study of docetaxel and S-1 in combination with trastuzumab for HER2-positive advanced gastric cancer (DASH study). Cancer Chemother Pharmacol, 2018, 81(2): 387-392.
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27. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018 (5th edition). Gastric Cancer, 2021, 24(1): 1-21.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Current status and prospect of treatment of advanced gastric cancer

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