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Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Development of targeted therapies in advanced gastric cancer: promising exploratory steps in a new era
Anna D Wagner1, Markus Moehler
1Multidisciplinary Oncology Center, Lausanne University Hospital, Lausanne, Switzerland. dorothea.wagner@chuv.ch
Purpose Of Review:
Many chemotherapeutic drugs, including fluoropyrimidines, platinums, CPT-11, taxanes and adriamycin have single-agent activity in advanced gastric cancer. Although combination chemotherapy has been shown to be more effective than single agents, response rates between 30 and 50% have not fulfilled their promise as progression-free survival from the best combinations ranges between 3 and 7 months and overall survival between 8 and 11 months. The development of targeted therapies in gastric cancer clearly stays behind the integration of these novel agents into new treatment concepts for patients with colorectal cancer. This review summarizes the experience and major recent advances in the development of targeted therapies in advanced gastric cancer.
Recent Findings:
Recent publications on targeted therapies in gastric cancer are limited to nonrandomized phase I or II trials. The majority of agents tested were angiogenesis inhibitors or agents targeting the epidermal growth factor receptors epidermal growth factor receptor 1 and HER2.
Summary:
Adequately powered, randomized phase III trials are necessary to define the clinical role of targeted therapies in advanced gastric cancer. Biomarker studies to correlate with treatment outcomes will be critical to identify patients who benefit most from chemotherapy and targeted therapy.
Insights
Targeted therapies show promise for advanced gastric cancer, but more research is needed. Randomized trials and biomarker studies are crucial to identify effective treatments and patient subgroups for gastric cancer therapy.
Area of Science:
- Oncology
- Gastrointestinal Oncology
- Cancer Therapeutics
Background:
- Advanced gastric cancer treatment relies on chemotherapy, with limited survival benefits.
- Combination chemotherapy shows modest response rates but fails to significantly extend progression-free or overall survival.
- Targeted therapy development in gastric cancer lags behind other cancers like colorectal cancer.
Purpose of the Study:
- To review the current experience and recent advancements in targeted therapies for advanced gastric cancer.
- To highlight the progress and challenges in integrating novel agents into gastric cancer treatment paradigms.
Main Methods:
- Review of recent publications focusing on targeted therapies in advanced gastric cancer.
- Analysis of data from nonrandomized phase I and II trials.
Main Results:
- Current research on targeted therapies is primarily based on nonrandomized phase I/II trials.
- Angiogenesis inhibitors and agents targeting epidermal growth factor receptors (EGFR1 and HER2) are the main classes of targeted agents investigated.
Conclusions:
- Robust, randomized phase III trials are essential to establish the clinical utility of targeted therapies in advanced gastric cancer.
- Biomarker studies are critical for identifying patient populations who will benefit most from targeted and chemotherapy combinations.
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