胃癌靶向药物治疗进展.pdfVIP

《中国医学前沿杂志 （电子版）》2013年第5卷第1期 ● 专家论坛 ● 29 胃癌靶向药物治疗进展 1 2 邓薇 ，沈琳 （1.首都医科大学附属北京友谊医院　普外科，北京　100050；2.北京大学临床肿瘤学院　 北京肿瘤医院　消化肿瘤内科，北京　100036） 【摘要】　胃癌是消化系统常见的恶性肿瘤之一，由于早诊率低，大多数患者在诊断时已经处于疾病 中晚期。化疗是进展期胃癌的重要治疗方法，但是，细胞毒性药物联合方案并没有从根本上提高化疗 有效率。分子靶向治疗是近年来在治疗血液系统肿瘤和实体瘤中涌现出的新治疗手段。随着对胃癌发 生、发展和转移过程中分子生物学机制的研究，这种治疗手段也逐步应用于胃癌治疗的临床实践。这 些靶向治疗策略主要包括：HER2单克隆抗体，表皮生长因子受体抑制剂，血管生成抑制剂，多靶点 酪氨酸激酶抑制剂，细胞周期蛋白依赖性激酶 （CDKs ），mTOR抑制剂，c-Met抑制剂，基质金属蛋 白酶抑制剂，IGF- 1R抑制剂，HSP 90抑制剂等。本文就进展期胃癌近年来分子靶向治疗的研究结果 及相关进展作一综述。 【关键词】　胃癌；曲妥珠单抗；贝伐单抗；西妥昔单抗；多靶点酪氨酸激酶抑制剂；Favopiridol ； RAD001；Figitumumab ；17-AAG ；Foretinib Abstract Gastric cancer is one of the most common malignancies in the digestive system. Due to the 【 】 low rate of diagnosis, most of the patients with gastric cancer have advanced disease at the time of diagnosis. Chemotherapy is still the mainstay of treatment for advanced gastric cancer, but efficacy of combination chemotherapy is modest. Novel treatment options are urgently needed to improve the outcome of patients with advanced gastric cancer. Molecular targeted therapies have emerged as a novel approach to the treatment of both hematological and solid tumors in recent years. The study of molecular biological mechanisms underlying the formation, progression and metastasis in advanced gastric cancer has enabled us to use the new approach to treat this disease in clinical practice. These therapeutic strategies include targeting EGFR signal transduction pathway, HER2 monoclonal antibody, anti-angiogenesis, multityrosine kinase inhibitors, cyclin dependent kinase (CDK) inhibitors c-Met inhibitors, PI3k/Akt/mTOR pathway inhibitors, Matrix metalloproteinase, IGF-1R inhibitors, and HSP 90 inhibitors. The aim of this review is to summarize the most recent publications on targeted therapies in advanced gastric cancer. Key words Gastric cancer; Trastuzumab; Bevacizumab; Cetuximab; Multityrosin