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Published on: May 10, 2024
[Research status quo and progression in targeted therapy for advanced gastric cancer]
Rui Feng1, Xiaotian Zhang2, Sheng Yang3
1Teaching and Research Department of Oncology, Union Clinical Medical College of Fujian Medical University, Fuzhou 350001, China.
Abstract:
With the deeper research of the proliferation, invasion and metastasis mechanisms of the gastric cancer, targeted therapy has become a hot spot in this field. The exploration of targeted agents for gastric cancer is mainly concentrated upon the drugs that target human epidermal growth factor receptor (HER) family, the vascular endothelial growth factor (VEGF), the phosphatidylinositol 3-kinase-protein kinase/mammalian target of rapamycin (PI3K/mTOR) and the NF-κB signaling pathways. The targeted drugs relevant to HER family include the Cetuximab, Nimotuzumab, Matuzumab, Panitumumab and Erlotinib which are aimed at HER-1, the Trastuzumab, Pertuzumab and T-DM1 (trastuzumab emtansine) which are aimed at HER-2, and the Lapatinib and Afatinib which are the multi-target agents of HER. The agents which target VEGF signaling pathway include the anti-VEGF monoclonal antibody (Bevacizumab), the anti-VEGFR drugs (Ramucirumab, Apatinib, Sorafenib, Sunitinib and cediranib), and the recombinant fusion protein (Aflibercept). The LY294002, BEZ235 and Everolimus which are aimed at PI3K/mTOR signaling pathway have shown great promise. Bortezomib has been researched more as a new agent which targets NF-κB signaling pathway. Currently, only Trastuzumab, Ramucirumab and Apatinib have been completed the stage 3 clinical trials and succeeded. In future, researches should focus on multi-target agents or applications in combination treatment. This review collects the recent researches and the clinical trials to summarize the current state and progress of research on gastric cancer targeted therapy.
Insights
Targeted therapies for gastric cancer focus on pathways like HER, VEGF, PI3K/mTOR, and NF-κB. Trastuzumab, Ramucirumab, and Apatinib are approved, with future research exploring combination treatments.
Area of Science:
- Oncology
- Pharmacology
Background:
- Gastric cancer progression involves complex mechanisms like proliferation, invasion, and metastasis.
- Targeted therapy represents a significant advancement in gastric cancer treatment.
Purpose of the Study:
- To review current research and clinical trials on targeted agents for gastric cancer.
- To summarize the progress and future directions in gastric cancer targeted therapy.
Main Methods:
- Literature review of recent research on gastric cancer targeted therapy.
- Analysis of clinical trial data for targeted agents.
Main Results:
- Targeted agents primarily focus on the human epidermal growth factor receptor (HER) family, vascular endothelial growth factor (VEGF), phosphatidylinositol 3-kinase-protein kinase/mammalian target of rapamycin (PI3K/mTOR), and NF-κB signaling pathways.
- Trastuzumab, Ramucirumab, and Apatinib are the only agents that have successfully completed Phase 3 clinical trials.
- Several agents targeting HER family (e.g., Cetuximab, Trastuzumab, Lapatinib) and VEGF (e.g., Bevacizumab, Ramucirumab, Apatinib) are under investigation.
Conclusions:
- Future research should prioritize the development of multi-target agents and combination therapies for gastric cancer.
- Continued investigation into targeted therapies offers promise for improving patient outcomes in gastric cancer.
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