Onkologie. 2015:9(6):277-281

New agents for treatment of gastric cancer

Radka Obermannová¹, Kristýna Melichárková², Rostislav Vyzula¹

¹ Klinika komplexní onkologické péče, MOU a LF MU v Brně

² Klinika dětské onkologie LF MU a FN Brno

Gastric cancer is the third most common cause of cancer death worldwide. Although the overall incidence and mortality of this disease

have dramatically declined over the last few decades, the prognosis remains poor with the five year overall survival rate approaching

zero. Targeted therapy may offer new possibilities for the treatment of gastric cancer. Only two targeted agents have reached common

use in a metastatic setting: trastuzumab and ramucirumab. Trastuzumab monoclonal HER2 antibody used in combination with chemotherapy

versus chemotherapy alone, demonstrated a significant increase in overall survival in HER2 positive patients treated in first

line therapy. Ongoing trials are investigating the efficacy of the combination of the two anti-HER2 monoclonal antibodies trastuzumab

plus pertuzumab in first-line advanced gastric cancer and the antibody-cytotoxic drug conjugate trastuzumab-emtansine (TDM-1) in

second-line advanced gastric cancer. INNOVATION is an ongoing phase III trial which should determine the benefit of HER2 treatment

in a perioperative setting. Ramucirumab, a fully humanized monoclonal antibody against VEGFR-2, also entered into clinical practice

and is effective in second-line gastric cancer given either alone or in combination with paclitaxel. The role of the other receptor tyrosine

kinases, such as EGFR, MET and FGFR for drug therapy in gastric cancer remains to be determined. Agents targeting these other tyrosine

kinase receptors have been widely tested and large scale studies with the corresponding inhibitors were unsuccessful. The optimal

drug/patient choice is challenging and should be elucidated. Choosing the optimal drug for a specific patient is challenging and requires

further research to be better understood. Immunotherapy, especially the immune checkpoint blockade is gradually becoming integrated

into clinical practice. While immunotherapy is effective in treating tumors like melanoma and non-small cell lung cancer, its effectiveness

in treating gastric cancer has yet to be determined: Phase II/III clinical trials in gastrointestinal and gastric cancers are still ongoing.

The article summarizes modern targeted agents, which have already been tested, are in clinical use or could enter into clinical practice.

Keywords: gastric cancer, targeted therapy, clinical praktice

Published: December 1, 2015  Show citation