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Targeted therapies in gastric cancer treatment: where we are and where we are going
Gianluca Tomasello1, Michele Ghidini2, Wanda Liguigli2
1Oncology Division, Azienda Socio Sanitaria Territoriale di Cremona, Ospedale di Cremona, Viale Concordia 1, 26100, Cremona, Italy. g.tomasello@ospedale.cremona.it.
Abstract:
Gastric cancer (GC) is one of the most common malignancies and a major cause of cancer-related deaths worldwide. Its incidence has significantly declined over the last few decades, probably due to the identification of specific etiologic agents such as Helicobacter pylori and other dietary and environmental risk factors. Nevertheless, most of the cases are unfortunately diagnosed at an advanced stage justifying median overall survival rates frequently not exceeding one year. Palliative combination chemotherapy usually represented by a platinum-based doublet is the mainstay of treatment in the metastatic setting. Adding a third drug such as an anthracycline or a taxane has been shown to improve response rate and provide limited survival benefits in fit selected patients. Unlike other tumors, the introduction of molecularly targeted drugs in the medical armamentarium for GC is relatively recent with trastuzumab and ultimately ramucirumab constituting the only agents approved to date. Recent advances in the understanding of GC biology have led to the development of novel targeted therapies holding the promise to further improve treatment outcomes. The aim of this paper is to review the main available data coming from clinical trials of targeted drugs and to describe some of the most interesting molecules in clinical development in GC. These include drugs targeting EGFR, angiogenesis, c-MET, FGFR2, mTOR and immune checkpoints.
Insights
Gastric cancer (GC) survival is poor, with advanced stages diagnosed frequently. This review covers targeted therapies, including new drugs for EGFR, angiogenesis, and immune checkpoints, to improve outcomes.
Area of Science:
- Oncology
- Gastroenterology
- Pharmacology
Background:
- Gastric cancer (GC) remains a leading cause of cancer mortality globally.
- Despite declining incidence, many cases present at advanced stages, limiting treatment efficacy.
- Current treatments, including chemotherapy and limited targeted agents like trastuzumab and ramucirumab, offer modest survival benefits.
Purpose of the Study:
- To review clinical trial data for targeted drugs in gastric cancer.
- To highlight promising novel targeted therapies in clinical development for GC.
- To provide an overview of agents targeting EGFR, angiogenesis, c-MET, FGFR2, mTOR, and immune checkpoints.
Main Methods:
- Literature review of clinical trials involving targeted therapies for gastric cancer.
- Analysis of data on approved and investigational targeted agents.
- Focus on molecular targets including EGFR, angiogenesis, c-MET, FGFR2, mTOR, and immune checkpoints.
Main Results:
- Trastuzumab and ramucirumab are currently the only approved targeted therapies for GC.
- Several novel targeted agents show promise in clinical development, targeting various pathways.
- Emerging therapies aim to improve response rates and survival in advanced GC.
Conclusions:
- Targeted therapies represent a growing area of treatment for gastric cancer.
- Ongoing research into novel molecular targets holds significant promise for improving patient outcomes.
- A deeper understanding of GC biology is crucial for developing effective targeted treatment strategies.
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