[胃癌有什么新发现?]
Michael Masetti1, Sylvie Lorenzen1
1Klinik und Poliklinik für Innere Medizin III, Klinikum rechts der Isar der TU München, München, Deutschland.
Deutsche medizinische Wochenschrift (1946)
|August 15, 2024
概括
免疫疗法和向疗法对晚期胃癌有希望,改善转移性环境中的生存率. 虽然一些试验显示出良好的病理性缓解,但所有患者的生存益处需要进一步调查.
科学领域:
- 在瘤学瘤学.
- 胃肠道癌症研究研究
- 免疫治疗是一种免疫疗法.
背景情况:
- 诸如周术化疗和新辅助放射化疗之类的多式疗法是局部晚期胃癌的标准.
- 将免疫疗法纳入现有治疗方案可能会改善患者的预后.
- 目前的研究正在探索针对晚期和转移性胃癌的新型免疫疗法和向药物.
研究的目的:
- 审查免疫疗法和向治疗在胃癌治疗中的有效性.
- 评估新治疗策略对生存率和缓解率的影响.
- 突出胃癌的第一线和第二线治疗选择的进展.
主要方法:
- 对II/III期临床试验的分析 (例如,丹特,凯诺特-585,马特霍恩,检查-649,凯诺特-859,凯诺特-811).
- 在PD-L1阳性瘤中对免疫疗法 (pembrolizumab,nivolumab) 的评估.
- 对HER2阳性瘤的组合疗法 (使用抗HER2的免疫疗法) 的评估.
- 对抗体 - 药物合物 (特拉斯图祖马布 - 德鲁克斯坦) 和双特异性抗体 (扎尼达达马布) 的审查.
- 对针对CLDN18.2和FGFR2b的向治疗方法的检查,包括佐尔贝图西马布.
主要成果:
- 免疫疗法整合显示出有希望的病理性缓解率,但在未选择的患者中可变的生存延长.
- 像CheckMate-649和KEYNOTE-859这样的研究表明,免疫疗法在转移性胃癌中改善了存活率和反应率.
- 布罗利祖马布和尼沃卢马布已被批准用于PD-L1阳性胃瘤的第一线治疗.
- 结合免疫检查点抑制剂和抗HER2药物的组合疗法有利于HER2阳性患者 (KEYNOTE-811).
- 特拉斯图祖马布-德鲁克斯坦显示出作为第二线治疗HER2阳性胃癌的潜力.
- 在一线治疗中,zolbetuximab在CLDN18.2阳性胃癌患者的生存率得到改善.
结论:
- 免疫疗法和向疗法代表了胃癌治疗的重大进展,特别是转移性疾病.
- 虽然病理反应令人鼓舞,但需要进一步的研究来优化不同患者群体的生存益处.
- 针对PD-L1,HER2,CLDN18.2和FGFR2b等特定生物标志物的新药提供了个性化的治疗策略和更好的结果.
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