[胃癌有什么新进展?]

Deutsche medizinische Wochenschrift (1946) Pub Date : 2024-08-01 Epub Date: 2024-08-15 DOI:10.1055/a-2179-0830
Michael Masetti, Sylvie Lorenzen
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引用次数: 0

摘要

在局部晚期阶段,建议采用多模式疗法,如使用FLOT的围手术期化疗或新辅助放化疗。将免疫疗法纳入这些概念可改善预后。DANTE、KEYNOTE-585和MATTERHORN等II/III期试验显示,病理缓解方面的结果很有希望,但迄今为止,未入选患者生存时间延长方面的数据令人担忧。免疫疗法和新型靶向疗法为转移性胃癌的姑息治疗带来了希望。CheckMate-649和KEYNOTE-859等研究显示,生存率和反应率都有所提高。目前,pembrolizumab 和 nivolumab 已被批准用于 PD-L1 表达阳性肿瘤的一线治疗。对于 HER2 阳性肿瘤,KEYNOTE-811 研究表明,患者可从免疫检查点抑制剂和抗 HER2 疗法的联合治疗中获益。此外,双特异性抗体扎尼他单抗(zanidatamab)在一线治疗中也显示出良好的效果。针对CLDN18.2和FGFR2b的新靶向疗法也显示出良好的效果。抗CLDN18.2(CLDN18.2)抗体唑贝妥昔单抗(zolbetuximab)在一线治疗中与单纯化疗相比,可提高CLDN18.2阳性患者的生存率,预计将于2024年获得批准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[What's new in gastric cancer?]

In the locally advanced stage, multimodal therapies such as perioperative chemotherapy with FLOT or neoadjuvant radiochemotherapy are recommended. The integration of immunotherapy into these concepts could improve the prognosis. Phase II/III trials such as DANTE, KEYNOTE-585 and MATTERHORN show promising results in terms of pathological remissions but data on survival time extension for unselected patients are so far sobering. Immunotherapies and new targeted therapies offer hope in the palliative treatment of metastatic gastric cancer. Studies such as CheckMate-649 and KEYNOTE-859 show an improvement in survival and response rates. Currently, both pembrolizumab and nivolumab have been approved for the first-line treatment of tumors with positive PD-L1 expression. In HER2-positive tumors, the KEYNOTE-811 study showed that patients benefit from combination therapies with immune checkpoint inhibition and anti-HER2 therapies. The antibody-drug conjugate trastuzumab-deruxtecan is a promising second-line treatment option for HER2-positive tumors after treatment failure with trastuzumab.In addition, the bispecific antibody zanidatamab shows promising results in first-line treatment. New targeted therapies against CLDN18.2 and FGFR2b are showing promising results. The anti-claudin 18.2 (CLDN18.2) antibody zolbetuximab leads to improved survival compared to chemotherapy alone in patients with CLDN18.2 positive disease in first-line therapy, with approval expected in 2024.

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