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胃癌是消化系统常见的恶性肿瘤之一,大多数患者在诊断时已经处于疾病晚期。化疗仍是晚期胃癌的主要治疗方法,但是化疗的疗效难尽如人意。分子靶向治疗是近年来在治疗血液和实体肿瘤中涌现出的新治疗手段。随着对存在于胃癌发生、发展和转移过程中分子生物学机制的研究,也逐步将这种治疗手段应用于胃癌治疗的临床实践。目前这种治疗策略主要包括靶向于EGFR通路、抗血管生成、靶向于NF-κB信号传导通路以及细胞周期素激酶抑制剂等。本文就此作简要介绍,如抗血管生成有抗VEGF单抗贝伐单抗已经得到FDA批准临床应用,并有联合化疗药物治疗转移性胃癌的报道;抑制NF-κB信号传导通路的现有PS-341(蛋白酶体抑制剂,borte-zom ib),FDA已经批准该药用于难治性或复发性多发性骨髓瘤的治疗,PS-341联合化疗药治疗胃癌已有报道;靶向EGFR、HER2信号通路的药物有西妥昔单抗(cetuxim ab)、EMD72000(m atuzum ab)、吉非替尼(gefitin ib)、埃罗替尼(erlotin ib)、曲妥珠单抗(trastuzum ab)等,也有联合化疗的报道,且令人鼓舞,针对细胞周期调节的治疗有flavop iri-dol,为小分子周期素依赖激酶抑制蛋白(CDK I),仍需进一步进行临床试验。
Gastric cancer is one of the most common malignant tumors in the digestive system. Most patients are already diagnosed with advanced disease. Chemotherapy is still the main treatment of advanced gastric cancer, but the curative effect of chemotherapy is unsatisfactory. Molecular targeted therapy is a new treatment that has emerged in the treatment of blood and solid tumors in recent years. With the existence of gastric cancer in the process of development, development and metastasis of molecular biological mechanisms, but also gradually apply this treatment in the clinical practice of gastric cancer treatment. At present, this therapeutic strategy mainly includes targeting EGFR pathway, anti-angiogenesis, targeting NF-κB signaling pathway and cyclin kinase inhibitors. This article gives a brief introduction, such as anti-angiogenic anti-VEGF monoclonal antibody bevacizumab has been approved by the FDA clinical application, and combined chemotherapy drugs for the treatment of metastatic gastric cancer reports; inhibition of NF-κB signaling pathway existing PS- 341 (proteasome inhibitor, borte-zom ib), the FDA has approved the drug for the treatment of refractory or relapsed multiple myeloma, PS-341 combined chemotherapy drugs for the treatment of gastric cancer have been reported; targeted EGFR, HER2 Drugs for signaling pathways are cetuxim ab, muzuzum ab, gefitinib, erlotin ib, trastuzuma ab, etc. , And there are reports of combined chemotherapy, and encouraging, flavopridium, a small molecule of cyclin-dependent kinase inhibitor protein (CDK I) for the treatment of cell cycle regulation, still need further clinical trials.