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Advanced gastric cancer:Is there enough evidence to call second-line therapy standard?

World Journal of Gastroenterology 2012年第44期18卷 6376-6378页

作者： Hendrik-Tobias Arkenau matilde saggese Charlotte Lemech Drug Development Unit Sarah Cannon Research UKUniversity College LondonLondon W1G 6ADUnited Kingdom

Gastric cancer and cancer of the gastro-oesophageal junction(GOJ) are the 4th most common cancer diagnoses worldwide with regional differences in incidence *** treatment of gastric and GOJ cancers is complex and requires multimodality treatment including chemotherapy treatment,surgery,and *** the past decade considerable improvements were achieved by advanced surgical techniques,tailored chemotherapies/radiotherapy and technical innovations in clinical *** patients with advanced or metastatic gastric/GOJ cancer systemic chemotherapy with fluoropyrimidine/platinum-based regimens(+/-human epidermal growth factor receptor-2 antibody) is the mainstay of *** these improvements,the clinical outcome for patients with advanced or metastatic disease is generally poor with 5-year survival rates ranging between 5%-15%.These poor survival rates may to some extent be related that standard therapies beyond first-line therapies have never been *** that this patient population is often not fit enough to receive further treatments there is an increasing body of evidence from phase-2 studies that in fact second-line therapies may have a positive impact in terms of overall *** two recently published phase-3 studies support the use of second-line chemotherapy.A South Korean study compared either,irinotecan or docetaxel with best supportive care and a German study compared irinotecan with best supportive care-both studies met their primary endpoint overall *** this "Field of Vision" article,we review these recently published phase-3 studies and put them into the context of clinical prognostic factors helping to guide treatment decisions in patients who most likely benefit.

关键词： Gastric cancer Cancer of the gastro-esoph-ageal junction Second-line chemotherapy Best sup-portive care Survival

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