Abstract：
After immune checkpoint inhibitor (ICI) comes into third-line treatment of advanced gastric cancer, the therapeutic strategy has been dramatically changed. Recent first-line regimen, which consists of ICI and chemotherapeutic agents, prolonged progression-free survival, and subsequent treatment options enabled continuous treatment beyond second-line therapy. Moreover, the advent of vascular endothelial growth factor (VEGF)-targeted agents including angiogenesis inhibitors and TKIs provides an opportunity of considering the interaction between ICI and anti-VEGF agents, and facilitating novel treatment proposal. Although clinical benefit of prolonged VEGF blockade after disease progression has not been confirmed in gastric cancer, combination therapy of cytotoxic agents and anti-VEGF agent, such as irinotecan plus ramucirumab demonstrated favorable objective response rate and progression-free survival in third- or later-line setting. In this review, we discuss recent progress and future directions of later-line treatments of HER2-negative advancer gastric cancer.
摘要：
在免疫检查点抑制剂（ICI）进入晚期胃癌的三线治疗后，治疗策略发生了巨大变化.最近的一线治疗方案，由ICI和化疗药物组成，延长无进展生存期，和随后的治疗选择使得在二线治疗之外的连续治疗成为可能.此外，血管内皮生长因子（VEGF）靶向药物（包括血管生成抑制剂和TKIs）的出现提供了考虑ICI和抗VEGF药物之间相互作用的机会，并促进新的治疗建议。尽管在胃癌中尚未证实疾病进展后延长VEGF阻断的临床益处，细胞毒性药物和抗VEGF药物的联合治疗，伊立替康联合雷莫鲁单抗等在三线或后期治疗中表现出良好的客观缓解率和无进展生存期.在这次审查中,我们讨论了HER2阴性胃癌晚期治疗的最新进展和未来方向。
