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Monoclonal antibodies-based treatment in gastric cancer: current status and future perspectives
Giandomenico Roviello1, Karol Polom2, Roberto Petrioli3
1Section of pharmacology and University Center DIFF-Drug Innovation Forward Future, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25124, Brescia, Italy. giandomenicoroviello@hotmail.it.
Abstract:
Gastric cancer (GC) is the second leading cause of cancer-related death, and despite having improved treatment modalities over the last decade, for most patients, only modest improvements have been seen in overall survival. Recent progress in understanding the molecular biology of GC and the related signaling pathways offers, from the clinical point of view, promising advances for selected groups of patients. In the past, targeted therapies have significantly impacted the treatment strategy of several common solid tumors such as breast, colorectal, and lung cancers. Unfortunately, translational and clinical research shows fewer encouraging targeted treatments with regards to the GC. To date, only two monoclonal antibodies (mAb), named trastuzumab and ramucirumab, are approved for the treatment of advanced GC, suggesting that in GC, maybe more than in other cancers, effective targeted therapy requires patient selection based on precise predictive molecular biomarkers. The aim of this review is to summarize the available data on the clinical advantages offered by the use of mAbs in the treatment of advanced/metastatic GC. Future perspective is also discussed.
Insights
Gastric cancer (GC) treatment shows modest survival improvements. Targeted therapies using monoclonal antibodies (mAbs) offer promise for advanced GC, but require precise molecular biomarkers for patient selection.
Area of Science:
- Oncology
- Molecular Biology
- Gastroenterology
Background:
- Gastric cancer (GC) remains a leading cause of cancer mortality globally.
- Despite advances, overall survival improvements for GC patients have been limited.
- Targeted therapies have transformed other cancers, but show less impact in GC.
Purpose of the Study:
- To review the clinical benefits of monoclonal antibodies (mAbs) in advanced/metastatic gastric cancer.
- To highlight the importance of predictive molecular biomarkers in GC targeted therapy.
- To discuss future perspectives for mAb-based treatments in gastric cancer.
Main Methods:
- Literature review of clinical trials and translational research.
- Analysis of data on approved monoclonal antibodies (trastuzumab, ramucirumab).
- Evaluation of predictive biomarkers for targeted therapy in GC.
Main Results:
- Only two mAbs (trastuzumab, ramucirumab) are currently approved for advanced GC.
- Effective targeted therapy in GC necessitates rigorous patient selection.
- Significant progress in understanding GC molecular pathways offers potential for new treatments.
Conclusions:
- Monoclonal antibodies show clinical advantages in selected advanced/metastatic GC patients.
- Biomarker-driven patient selection is crucial for successful targeted therapy in GC.
- Further research into molecular targets and biomarkers is essential for advancing GC treatment.
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