Current status and perspectives of conversion therapy for advanced gastric cancer

IF 7 2区 医学 Q1 ONCOLOGY Chinese Journal of Cancer Research Pub Date : 2022-04-30 DOI:10.21147/j.issn.1000-9604.2022.02.05
Heli Yang, K. Ji, J. Ji
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引用次数: 4

Abstract

The concept and strategy of advanced gastric cancer treatment have gradually undergone profound changes with the in-depth understanding of the biology and heterogeneous characteristics of gastric cancer. Moreover, the development and application of new anticancer drugs, including chemotherapy drugs, molecularly targeted drugs and immunotherapy drugs for advanced gastric cancer are reported. The connotation of conversion therapy refers to the unresectable or borderline resectable tumors for surgical technical and/or oncological reasons, after active and effective chemotherapy and other comprehensive treatment, the primary gastric lesions can be reduced to a lower stage, while the metastatic lesions can be effectively controlled, to achieve R0 resection and improve the long-term survival rate. Current promising research results of conversion therapy are mostly from single-arm phase II clinical studies with small samples or retrospective studies. Conversion therapy still faces many challenges, including limited diagnostic and assessment methods, insufficient evidence of highly effective treatment regimens, difficulty in clarifying surgical indications, etc. Therefore, the integrated conversion therapy for advanced gastric cancer needs to be carried out with the close cooperation of a multidisciplinary team. Prospective, multi-center randomized controlled trial studies should be conducted in the future, and precision medicine such as molecular biology should be combined to provide better anticancer drug regimens and higher-level clinical evidence for conversion therapy of advanced gastric cancer.
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进展期胃癌转化治疗的现状及展望
随着对癌症生物学和异质性特征的深入理解,晚期癌症治疗的理念和策略逐渐发生了深刻的变化。此外,还报道了晚期癌症化疗药物、分子靶向药物和免疫治疗药物等新型抗癌药物的开发和应用。转化治疗的内涵是指由于手术技术和/或肿瘤学原因,不可切除或边缘可切除的肿瘤,经过积极有效的化疗和其他综合治疗,原发性胃病变可以降到较低阶段,而转移性病变可以得到有效控制,实现R0切除,提高远期生存率。目前有希望的转化治疗研究结果大多来自小样本的单臂II期临床研究或回顾性研究。转化治疗仍然面临许多挑战,包括诊断和评估方法有限、高效治疗方案证据不足、手术指征难以明确等。因此,晚期癌症的综合转化治疗需要在多学科团队的密切合作下进行。未来应开展前瞻性、多中心随机对照试验研究,结合分子生物学等精准医学,为晚期癌症转化治疗提供更好的抗癌药物方案和更高水平的临床证据。
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来源期刊
自引率
9.80%
发文量
1726
审稿时长
4.5 months
期刊介绍: Chinese Journal of Cancer Research (CJCR; Print ISSN: 1000-9604; Online ISSN:1993-0631) is published by AME Publishing Company in association with Chinese Anti-Cancer Association.It was launched in March 1995 as a quarterly publication and is now published bi-monthly since February 2013. CJCR is published bi-monthly in English, and is an international journal devoted to the life sciences and medical sciences. It publishes peer-reviewed original articles of basic investigations and clinical observations, reviews and brief communications providing a forum for the recent experimental and clinical advances in cancer research. This journal is indexed in Science Citation Index Expanded (SCIE), PubMed/PubMed Central (PMC), Scopus, SciSearch, Chemistry Abstracts (CA), the Excerpta Medica/EMBASE, Chinainfo, CNKI, CSCI, etc.
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