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Abstract：
Gastric cancer is one of the most lethal cancers worldwide despite many advances and options in therapy. As it is often diagnosed at an advanced stage, prognosis is poor with a median overall survival of less than twelve months. Chemotherapy remains the mainstay of treatment for these patients but it confers only a moderate survival advantage. There remains a need for new targeted treatment options and a way to better define patient populations who will benefit from these agents. In the past few years, there has been a better understanding of the biology, molecular profiling, and heterogeneity of gastric cancer. Our increased knowledge has led to the identification of gastric cancer subtypes and to the development of new targeted therapeutic agents. There are now two new targeted agents, trastuzumab and ramucirumab, that have recently been approved for the treatment of advanced and metastatic gastric cancer. There are also many other actively investigated targets, including epidermal growth factor receptor, the phosphatadylinositol 3-kinase/protein kinase B/mammalian target of rapamycin pathway, c-Met, poly ADP-ribose polymerase, and immune checkpoint inhibition. In this review, we discuss the current management of advanced gastric cancer as well as emerging targeted therapies and immunotherapy.
摘要：
胃癌是世界上最致命的癌症之一，尽管在治疗方面有许多进步和选择。因为它通常被诊断为晚期，预后较差,中位总生存期少于12个月.化疗仍然是这些患者的主要治疗方法，但它仅具有中等的生存优势。仍然需要新的靶向治疗选择和更好地定义将受益于这些药物的患者群体的方法。在过去的几年里,对生物学有了更好的理解，分子谱分析,和胃癌的异质性。我们不断增长的知识导致了胃癌亚型的鉴定和新的靶向治疗剂的开发。现在有两个新的目标特工，曲妥珠单抗和雷莫珠单抗，最近被批准用于治疗晚期和转移性胃癌。还有许多其他积极调查的目标，包括表皮生长因子受体,磷酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶途径，c-Met,聚ADP-核糖聚合酶，和免疫检查点抑制。在这次审查中,我们讨论了当前晚期胃癌的治疗方法以及新兴的靶向治疗和免疫疗法.
