Salati, Orsi, Smyth, Aprile, Beretta, De Vita, Di Bartolomeo, Fanotto, Lonardi, Morano, Pietrantonio, Pinto, Rimassa, Vasile, Vivaldi, Zaniboni, Ziranu, Cascinu (2019) Gastric cancer: Translating novels concepts into clinical practice Cancer treatment reviews 79() 101889


The overall 5-year survival of gastric cancer (GC) has change only little in the last decades and it remains the fifth leading cause of cancer-related death worldwide. However, in the past few years a more effective combination chemotherapy has raised the bar of curability of about 10% in resectable disease. Morever, a deeper knowledge of GC biology have unveiled biomarkers to help personalize adjunctive treatments in patients candidate to surgery. Despite a plateau in efficacy of fist-line treatment, incremental survival advantages have been recorded in unresectable advanced disease. The growing number of effective drugs in second and later lines along with a more judicious delivery of cytotoxics and early supportive interventions have enabled more patients to proceed beyond first-line. The continuum of care has become a reality in a considerable proportion of patients that offer opportunities to improve outcomes. Finally, the advent of the immune checkpoint inhibitors has brought great expectations in molecularly-defined subset of patients. This Review summarizes the state-of-the art in the management of GC together with novel concepts that have entered clinical development with the potential of change practice in the foreseeable future. Copyright © 2019 Elsevier Ltd. All rights reserved.

胃癌(GC)的整体5年生存率在过去几十年中变化不大,并且它仍然是全球癌症相关死亡的第五大原因。然而,在过去几年中,更有效的联合化疗使可切除疾病的可固化性提高了约10%。此外,更深入的GC生物学知识揭示了生物标志物,以帮助个体化候选手术患者的辅助治疗。尽管一线治疗的疗效达到稳定,但在无法切除的晚期疾病中已经记录了增量存活优势。越来越多的有效药物在第二次和晚期使用,同时更明智地提供细胞毒素和早期支持性干预措施,使更多的患者能够超越一线。在提供改善结果的机会的相当大比例的患者中,持续的护理已成为现实。最后,免疫检查点抑制剂的出现为分子定义的患者群体带来了很大的期望。本综述总结了GC管理的最新技术,以及在可预见的未来进入临床开发并具有变革实践潜力的新概念。版权所有©2019 Elsevier Ltd.保留所有权利。