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Multimodality management of resectable gastric cancer: A review

World Journal of Gastrointestinal Oncology 2014年第10期6卷 393-402页

作者： helen shum Lakshmi Rajdev Department of Oncology Montefiore Medical Center Albert Einstein College of MedicineBronx NY 10461 United States

Adenocarcinoma of the stomach carries a poor prognosis and is the second most common cause of cancer death worldwide. It is recommended that surgical resection with a D1 or a modified D2 gastrectomy(with at least 15 lymph nodes removed for examination), be performed in the United States, though D2 lymphadenectomies should be performed at experienced centers. A D2 lymphadenectomy is the recommended procedure in Asia. Although surgical resection is considered the definitive treatment, rates of recurrences are high, necessitating the need for neoadjuvant or adjuvant therapy. This review article aims to outline and summarize some of the pivotal trials that have defined optimal treatment options for non-metastatic non-cardia gastric cancer. Some of the most notable trials include the INT-0116 trial, which established a benefit in concurrent chemoradiation and adjuvant chemotherapy. This was again confirmed in the ARTIST trial, especially in patients with nodal involvement. Later, the Medical Research Council Adjuvant Gastric Infusional Chemotherapy trial provided evidence for the use of perioperative chemotherapy. Targeted agents such as ramucirumab and trastuzumab are also being investigated for use in locally advanced gastric cancers after demonstrating a benefit in the metastatic setting. Given the poor response rate of this difficult disease to various treatment modalities, numerous studies are currently ongoing in an attempt to define a more effective therapy, some of which are briefly introduced in this review as well.

关键词： Neoadjuvant chemotherapy Adjuvant che-motherapy Adjuvant chemoradiation Gastric cancer Gastric adenocarcinoma

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Anti-angiogenic agents in metastatic colorectal cancer

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World Journal of Gastrointestinal Oncology 2015年第7期7卷 71-86页

作者： Bhavana Konda helen shum Lakshmi Rajdev Department of Medical Oncology Albert Einstein College of Medicine/Montefiore Medical Center

Colorectal cancer(CRC) is a major public health concern being the third leading cause of cancer mortality in the United States. The availability of better therapeutic options has led to a decline in cancer mortality in these patients. Surgical resection should be considered in all stages of the disease. The use of conversion therapy has made surgery a potentially curative option even in patients with initially unresectable metastatic disease. In this review we discuss the role of various antiangiogenic agents in patients with metastatic CRC(m CRC). We describe the mechanism of action of these agents, and the rationale for their use in combination with chemotherapy. We also review important clinical studies that have evaluated the safety and efficacy of these agents in m CRC patients. Despite the discovery of several promising anti-angiogenic agents, m CRC remains an incurable disease with a median overall survival of just over 2 years in patients exposed to all available treatment regimens. Further insights into tumor biology and tumor microenvironment may help improve outcomes in these patients.

关键词： Anti-angiogenic agents Metastatic colorectalcancer Targeted agents Conversion therapy Colorectalmetastasectomy

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