进展期胃癌的治疗现状及进展
Treatment Status and Progress of Advanced Gastric Cancer
DOI: 10.12677/ACM.2023.134768, PDF,   
作者: 刘定定, 李雨婷:延安大学附属医院,陕西 延安 ;杨卫卫*:延安大学附属医院肿瘤科,陕西 延安
关键词: 进展期胃癌化疗放疗免疫治疗Advanced Gastric Cancer Chemotherapy Radiotherapy Immunotherapy
摘要: 胃癌作为一个全球性健康问题,因缺乏体检筛查的意识以及胃癌早期发病隐匿性,并且无明显的特异性症状,容易被忽略。故绝大部分患者在确诊时已是进展期胃癌,目前的医学进展,手术仍然是根治胃癌唯一可能的方法,随着对胃癌发病机制及生物学的不断深入研究,目前进展期胃癌患者以手术治疗为主,结合化、放疗、靶向治疗、免疫治疗的综合治疗模式,本文就目前进展期胃癌的治疗进展进行综述,旨在为进展期胃癌的精准治疗提供参考依据。
Abstract: As a global health problem, gastric cancer is easy to be ignored due to the lack of awareness of physical examination and screening, the occult early onset of gastric cancer, and no obvious specific symptoms. Therefore, most patients have advanced gastric cancer when they are diagnosed. With the current medical progress, surgery is still the only possible method for radical treatment of gas-tric cancer. With the continuous in-depth research on the pathogenesis and biology of gastric cancer, surgical treatment is the main treatment for patients with advanced gastric cancer, and the com-prehensive treatment mode of chemotherapy, radiotherapy, targeted therapy and immunotherapy is adopted. This article reviews the current progress in the treatment of advanced gastric cancer, aiming to provide reference for the precise treatment of advanced gastric cancer.
文章引用:刘定定, 李雨婷, 杨卫卫. 进展期胃癌的治疗现状及进展[J]. 临床医学进展, 2023, 13(4): 5419-5426. https://doi.org/10.12677/ACM.2023.134768

参考文献

[1] Torre, L.A., Siegel, R.L., Ward, E.M. and Jemal, A. (2016) Global Cancer Incidence and Mortality Rates and Trends—An Update. Cancer Epidemiology, Biomarkers & Prevention, 25, 16-27. [Google Scholar] [CrossRef
[2] Etemadi, A., Safiri, S., Sepanlou, S.G., et al. (2020) The Global, Regional, and National Burden of Stomach Cancer in 195 Countries, 1990-2017: A Systematic Analysis for the Global Burden of Disease Study 2017. The Lancet Gastroenterology and Hepatology, 5, 42-54.
[3] Etemadi, A., Safiri, S., Sepanlou, S.G., et al. (2020) The Global, Regional, and National Burden of Stomach Cancer in 195 Countries, 1990-2017: A Systematic Analysis for the Global Burden of Disease Study 2017. The Lancet Gastroenterology and Hepatology, 5, 42-54. [Google Scholar] [CrossRef
[4] Bray, F., Ferlay, J., Soerjomataram, I., et al. (2018) Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Can-cers in 185 Countries. CA: A Cancer Journal for Clinicians, 68, 394-424. [Google Scholar] [CrossRef] [PubMed]
[5] World Health Organization, International Agency for Research on Cancer (2020) GLOBOCAN 2020: Stomach Cancer Fact Sheet.
[6] 留成, 陈建思, 覃宇周, 黄名威, 金钦文. 进展期胃癌新辅助治疗病理完全缓解的研究进展[J]. 中国癌症防治杂志, 2021, 13(5): 559-564.
[7] Cunningham, D., Allum, W.H., Stenning, S.P., et al. (2006) Perioperative Chemotherapy versus Surgery Alone for Resectable Gastroesophageal Cancer. The New England Journal of Medicine, 355, 11-20. [Google Scholar] [CrossRef
[8] Batran, S.E., Homann, N., Pauligk, C., et al. (2019) Perioperative Chemotherapy with Fluorouracil plus Leucovorin, Oxaliplatin, and Docetaxel versus Fluorouracil or Capecitabine plus Cisplatin and Epirubicin for Locally Advanced, Resectable Gastric or Gastro-Oesophageal Junction Adenocarcinoma (FLOT4): A Randomised, Phase 2/3 Trial. The Lancet, 393, 1948-1957. [Google Scholar] [CrossRef
[9] Tsuburaya, A., et al. (2014) Neoadjuvant Chemotherapy with S-1 and Cisplatin Followed by D2 Gastrectomy with Para-Aortic Lymph Node Dissection for Gastric Cancer with Ex-tensive Lymph Node Metastasis. British Journal of Surgery, 101, 653-660. [Google Scholar] [CrossRef] [PubMed]
[10] Hang, X.T., Liang, H., Li, Z.Y., et al. (2021) Perioperative or Postoperative Adjuvant Oxaliplatin with S-1 versus Adjuvant Oxaliplatin with Capecitabine in Patients with Locally Advanced Gastric or Gastro-Oesophageal Junction Adenocarcinoma Undergoing D2 Gastrectomy (RESOLVE): An Open-Label, Superior-ity and Non-Inferiority, Phase 3 Randomised Controlled Trial. The Lancet Oncology, 22, 1081-1092. [Google Scholar] [CrossRef
[11] Xie, T.Y., et al. (2020) Early Results of the Randomized, Multicenter, Controlled Evaluation of S-1 and Oxaliplatin as Neoadjuvant Chemotherapy for Chinese Advanced Gastric Cancer Patients (RESONANCE Trial). Journal of Clinical Oncology, 38, 280. [Google Scholar] [CrossRef
[12] Fukagawa, T., Katai, H., Mizusawa, J., et al. (2018) A Prospective Multi-Institutional Validity Study to Evaluate the Accuracy of Clinical Diagnosis of Pathological Stage III Gastric Cancer (JCOG1302A). Gastric Cancer, 21, 68-73. [Google Scholar] [CrossRef] [PubMed]
[13] Stahl, M., Walz, M.K., Riera-Knorrenschild J., et al. (2017) Pre-operative Chemotherapy versus Chemoradiotherapy in Locally Advanced Adenocarcinomas of the Oesophagogastric Junction (POET): Long-Term Results of a Controlled Randomised Trial. European Journal of Cancer, 81, 183-190. [Google Scholar] [CrossRef] [PubMed]
[14] Ajani, J.A., Winter, K., Okawara, G.S., et al. (2006) Phase II Trial of Preoperative Chemoradiation in Patients with Localized Gastric Adenocarcinoma (RTOG 9904): Quality of Combined Modality Therapy and Pathologic Response. Journal of Clinical Oncology, 24, 3953-3958. [Google Scholar] [CrossRef
[15] Hofheinz, R.D., Haag, G.M., Ettrich, T.J., et al. (2020) Periopera-tive Trastuzumab and Pertuzumab in Combination with FLOT versus FLOT Alone for HER2-Positive Resectable Esophagogastric Adenocarcinoma: Final Results of the PETRARCA Multicenter Randomized Phase II Trial of the AIO. Journal of Clinical Oncology, 38, 4502. [Google Scholar] [CrossRef
[16] Zheng, Y.N., Yang, X., Yan, C., et al. (2020) Effect of Apatinib plus Neoadjuvant Chemotherapy Followed by Resection on Pathologic Response in Patients with Locally Ad-vanced Gastric Adenocarcinoma: A Single-Arm, Open-Label, Phase II Trial. European Journal of Cancer, 130, 12-19. [Google Scholar] [CrossRef] [PubMed]
[17] Japanese Gastric Cancer Association (2021) Japanese Gastric Can-cer Treatment Guidelines 2018 (5th Edition). Gastric Cancer, 24, 1-21. [Google Scholar] [CrossRef] [PubMed]
[18] Kaminishi, M., Yamaguchi, H., Shimizu, N., et al. (1997) Stom-ach-Partitioning Gastrojejunostomy for Unresectable Gastric Carcinoma. The Archives of Surgery, 132, 184-187. [Google Scholar] [CrossRef] [PubMed]
[19] Fujitani K., Yang, H.K., Mizusawa, J., et al. (2016) Gastrectomy plus Chemotherapy versus Hemotherapy Alone for Advanced Gastric Cancer with a Single Non-Curable Factor (REGATTA): A Phase 3, Randomised Controlled Trial. The Lancet Oncology, 17, 309-318. [Google Scholar] [CrossRef
[20] Shen, J., Ma, X., Yang, J., et al. (2020) Digestive Tract Re-construction Options after Laparoscopic Gastrectomy for Gastric Cancer. World Journal of Gastrointestinal Oncology, 12, 21-36. [Google Scholar] [CrossRef] [PubMed]
[21] 陈起跃, 钟情, 刘治羽, 黄晓波, 阙思瑾, 郑文泽, 李平, 郑朝辉, 黄昌明. 腹腔镜进展期胃癌根治术在中国的进展[J]. 中国肿瘤临床, 2021, 48(3): 110-117.
[22] Moertel, C., Reitemeier, R., Childs, D., Colby, M. and Holbrook, M. (1969) Combined 5-Fluorouracil and Supervoltage Radiation Therapy of Locally Unresectable Gastrointestinal Cancer. The Lancet, 294, 865-867. [Google Scholar] [CrossRef
[23] Gastrointestinal Tumor Study Group (1982) A Comparison of Combination Chemotherapy and Combined Modality Therapy for Locally Advanced Gastric Carcinoma. Cancer, 49, 1771-1777. http://www.ncbi.nlm.nih.gov/pubmed/6176313 [Google Scholar] [CrossRef
[24] Macdonald, J.S., Smalley, S.R., Benedetti, J., Hundahl, S.A., Estes, N.C., Stemmermann, G.N., et al. (2001) Chemoradiotherapy af-ter Surgery Compared with Surgery Alone for Adenocarcinoma of the Stomach or Gastroesophageal Junction. The New England Journal of Medicine, 345, 725-730. [Google Scholar] [CrossRef
[25] Bang, Y.J., Kim, Y.W., Yang, H.K., et al. (2012) Adjuvant Capecitabine and Oxaliplatin for Gastric Cancer after D2 Gastrectomy (CLASSIC): A Phase 3 Open-Label, Randomised Controlled Trial. The Lancet, 379, 315-321. [Google Scholar] [CrossRef
[26] Smalley, S.R., Benedetti, J.K., Haller, D.G., Hundahl, S.A., Estes, N.C., Ajani, J.A., et al. (2012) Updated Analysis of SWOG-Directed Intergroup Study 0116: A Phase III Trial of Adjuvant Radiochemotherapy versus Observation after Curative Gastric Cancer Resection. Journal of Clinical Oncology, 30, 2327-2333. [Google Scholar] [CrossRef
[27] Sasako, M., Sakuramoto, S., Katai, H., et al. (2011) Five-Year Outcomes of a Randomized Phase III Trial Comparing Adjuvant Chemotherapy with S-1 versus Surgery Alone in Stage II or III Gastric Cancer. Journal of Clinical Oncology, 29, 4387-4293. [Google Scholar] [CrossRef
[28] Yoshida, K., Kodera, Y., Kochi, M., et al. (2019) Addition of Docetaxel to Oral Fluoropyrimidine Improves Efficacy in Patients with Stage III Gastric Cancer: Interim Analysis of JACCRO GC-07, a Randomized Controlled Trial. Journal of Clinical Oncology, 37, 1296-1304. [Google Scholar] [CrossRef
[29] (2019) Interim Results of a Phase III Trial Involving Adjuvant Chemo-therapy and/or Chemoradiotherapy after D2-Gastrectomy in Stage II/III Gastric Cancer (GC). ASCO Annual Meeting, Chicago, 31 May-4 June 2019, Abstract 4001. [Google Scholar] [CrossRef
[30] Macedo, F., Ladeira, K., Longatto-Filho, A., et al. (2017) Gastric Cancer and Angiogenesis: Is VEGF a Useful Biomarker to As-sess Progression and Remission? Journal of Gastric Cancer, 17, 1-10. [Google Scholar] [CrossRef] [PubMed]
[31] Mawalla, B., Yuan, X., Luo, X., et al. (2018) Treatment Outcome of Anti-Angiogenesis through VEGF-Pathway in the Management of Gastric Cancer: A Systematic Review of Phase II and III Clinical Trials. BMC Research Notes, 11, 21-22. [Google Scholar] [CrossRef] [PubMed]
[32] Chuman, M., Takahashi, Y., Tokito, T., et al. (2019) A Case of Recurrent Gastric Cancer with Clinical Complete Response after Ramucirumab plus Paclitaxel Therapy. Gan to Kagaku Ryoho, 46, 1931-1933.
[33] Kawai, S., Fukuda, N., Yamamoto, S., et al. (2020) Retrospective Observational Study of Salvage Line Ramucirumab Monotherapy for Patients with Ad-vanced Gastric Cancer. BMC Cancer, 20, 338-340. [Google Scholar] [CrossRef] [PubMed]
[34] Jang, J., Kim, H.K., Bang, H., et al. (2017) Antitumor Effect of AZD4547 in a Fibroblast Growth Factor Receptor 2-Amplified Gastric Cancer Patient-Derived Cell Model. Translation-al Oncology, 10, 469-475. [Google Scholar] [CrossRef] [PubMed]
[35] Li, J., Qin, S., Xu, J., et al. (2016) Randomized, Double-Blind, Placebocontrolled Phase III Trial of Apatinib in Patients with Chemotherapy Refractory Advanced or Metastatic Adeno-carcinoma of the Stomach or Gastroesophageal Junction. Journal of Clinical Oncology, 34, 1448-1454. [Google Scholar] [CrossRef
[36] Aguilar-Mahecha, A., Joseph, S., Cavallone, L., et al. (2019) Pre-cision Medicine Tools to Guide Therapy and Monitor Response to Treatment in a HER-2+ Gastric Cancer Patient: Case Report. Frontiers in Oncology, 9, 698-699. [Google Scholar] [CrossRef] [PubMed]
[37] Muro, K., Chung, H., Shankaran, V., et al. (2016) Pembrolizumab for Patients with PD-L1-Positive Advanced Gastric Cancer (KEYNOTE-012): A Multicentre, Open-Label, Phase 1b Tri-al. The Lancet Oncology, 17, 717-726. [Google Scholar] [CrossRef
[38] Fuchs, C.S., Doi, T., Jang, R.W., et al. (2018) Safety and Ef-ficacy of Pembrolizumab Monotherapy in Patients with Previously Treated Advanced Gastric and Gastroesophageal Junction Cancer: Phase 2 Clinical KEYNOTE-059 Trial. JAMA Oncology, 4, e180013. [Google Scholar] [CrossRef] [PubMed]
[39] Kang, Y.-K., Boku, N., Satoh, T., et al. (2017) Nivolumab in Patients with Advanced Gastric or Gastro-Oesophageal Junction Cancer Refractory to, or Intolerant of, at Least Two Pre-vious Chemotherapy Regimens (ONO-4538-12, ATTRACTION-2): A Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial. The Lancet, 390, 2461-2471. [Google Scholar] [CrossRef
[40] Moehler, M., Dvorkin, M., Boku, N., et al. (2021) Phase III Trial of Avelumab Maintenance after First-Line Induction Chemotherapy versus Continuation of Chemotherapy in Pa-tients with Gastric Cancers: Results from JAVELIN Gastric 100. Journal of Clinical Oncology, 39, 966-977. [Google Scholar] [CrossRef
[41] Boku, N., Satoh, T., Ryu, M., Chao, Y., et al. (2021) Nivolumab in Previously Treated Advanced Gastric Cancer (ATTRACTION-2): 3-Year Update and Outcome of Treatment beyond Progression with Nivolumab. Gastric Cancer, 24, 946-958. [Google Scholar] [CrossRef] [PubMed]
[42] Peng, Z., Wei, J., Wang, F., et al. (2021) Camrelizumab Com-bined with Chemotherapy Followed by Camrelizumab plus Apatinib as First-Line Therapy for Advanced Gastric or Gas-troesophageal Junction Adenocarcinoma. Clinical Cancer Research, 27, 3069-3078. [Google Scholar] [CrossRef
[43] Wang, F., Wei, X.L., Wang, F.H., et al. (2019) Safety, Ef-ficacy and Tumor Mutational Burden as a Biomarker of Overall Survival Benefit in Chemo-Refractory Gastric Cancer Treated with Toripalimab, a PD-1 Antibody in Phase Ib/II Clinical Trial NCT02915432. Annals of Oncology, 30, 1479-1486.
[44] Jiang, H., Zheng, Y., Qian, J., et al. (2020) Safety and Efficacy of Sintilimab Combined with Oxali-platin/Capecitabine as First-Line Treatment in Patients with Locally Advanced or Metastatic Gastric/Gastroesophageal Junction Adenocarcinoma in a Phase Ib Clinical Trial. BMC Cancer, 20, 760. [Google Scholar] [CrossRef] [PubMed]
[45] U.S. Food and Drug Administration. (2021) FDA Grants Accel-erated Approval to Dostarlimab-Gxly for dMMR Advanced Solid Tumors.
https://www.fda.gov/drugs/resourcesinformation-approved-drugs/fda-grants-accelerated-approvaldostarlimab-gxly-dmmr-advanced-solid-tumors