PDF(Pubmed)
Abstract：
Gastric cancer and gastroesophageal junction cancer represent the leading cause of tumor-related death worldwide. Although advances in immunotherapy and molecular targeted therapy have expanded treatment options, they have not significantly altered the prognosis for patients with unresectable or metastatic gastric cancer. A minority of patients, particularly those with PD-L1-positive, HER-2-positive, or MSI-high tumors, may benefit more from immune checkpoint inhibitors and/or HER-2-directed therapies in advanced stages. However, for those lacking specific targets and unique molecular features, conventional chemotherapy remains the only recommended effective and durable regimen. In this review, we summarize the roles of various signaling pathways and further investigate the available targets. Then, the current results of phase II/III clinical trials in advanced gastric cancer, along with the superiorities and limitations of the existing biomarkers, are specifically discussed. Finally, we will offer our insights in precision treatment pattern when encountering the substantial challenges.
摘要：
胃癌和胃食管连接部癌是全球肿瘤相关死亡的主要原因。尽管免疫治疗和分子靶向治疗的进展扩大了治疗选择，对于不可切除或转移性胃癌患者，他们的预后没有显著改变。少数患者，特别是那些PD-L1阳性的，HER-2阳性,或MSI高肿瘤，可能从晚期阶段的免疫检查点抑制剂和/或HER-2定向疗法中受益更多。然而,对于那些缺乏特定靶标和独特分子特征的人，常规化疗仍然是唯一推荐的有效和持久的治疗方案.在这次审查中,我们总结了各种信号通路的作用，并进一步研究了可用的靶标。然后，晚期胃癌II/III期临床试验的当前结果，随着现有生物标志物的优势和局限性，具体讨论。最后,当遇到重大挑战时，我们将提供我们对精准治疗模式的见解。
