2022年度胃癌研究和诊疗新进展  

Advanced progress in research and diagnosis of gastric cancer in 2022

作　　者：蒋金玲[1] 周尘飞[1,2] 王超[1] 赵丽琴 吴珺玮[1,2] 张俊[1,2] JIANG Jinling;ZHOU Chenfei;WANG Chao;ZHAO Liqin;WU Junwei;ZHANG Jun(Department of Oncology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Oncology,Wuxi Branch of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Wuxi 214021,Jiangsu Province,China)

机构地区：[1]上海交通大学医学院附属瑞金医院肿瘤科,上海200025 [2]上海交通大学医学院附属瑞金医院无锡分院肿瘤科,江苏无锡214021

出　　处：《中国癌症杂志》2023年第4期303-314,共12页China Oncology

基　　金：国家自然科学基金(82273126,81972707,82103502);上海市卫生健康委协同创新集群计划(2020CXJQ03)。

摘　　要：胃癌是中国高发的消化道恶性肿瘤之一,5年相对生存率在40%左右,具有早诊率低、肿瘤负荷大、异质性强和患者预后差等特点。近20年,多学科团队诊疗模式、个体化精准决策成为公认的有效提升胃癌综合治疗效果的措施。在抗肿瘤药物治疗方面,已逐渐从“千人一方”的简单循证模式逐渐过渡到“精准免疫治疗”模式。2022年,胃癌的基础、临床和转化研究领域均取得了若干进展,覆盖分子机制探索、诊断技术及治疗策略等,其中尤以临床转化、精准医疗和免疫治疗等为研究热点。靶向药物的研究主要聚焦在为数不多的热门靶点(如CLDN18.2、FGFR2b)。免疫治疗领域国产程序性死亡[蛋白]-1(programmed death-1,PD-1)抑制剂逐渐崭露头角(RATIONALE 305研究),且更关注毒性的降低(Moonlight研究)及治疗新模式的探索(靶向治疗联合免疫治疗如LEAP-015临床研究、免疫治疗联合放疗如Neo-PLANET临床研究)。本文对2022年度胃癌研究进展进行总结,为更深入开展临床转化研究及临床实践的方案制订提供新的思路和建议。Gastric cancer is one of the malignant tumors with high incidence in China,with a 5-year relative survival rate of about 40%,which is characterized by low early diagnosis rate,large tumor load,high heterogeneity and poor prognosis.In the past 20 years,the multidisciplinary team model and individualized and precise decisions have become recognized measures to effectively improve the comprehensive treatment efficacy of gastric cancer.For the treatment of cancer,it has gradually transitioned from the simple evidence-based model of the“thousand people”to“precision immunotherapy”.The field of gastric cancer has made breakthroughs in many aspects in 2022,covering molecular mechanism exploration,diagnosis technology and treatment strategy,clinical transformation,precision medicine and immunotherapy became research hotspots.The research in targeted drugs mainly focus on a few hot targets(such as CLDN18.2 and FGFR2b).In the field of immunotherapy,domestic programmed death-1(PD-1)inhibitors are gradually emerging(in the study of RATIONALE 305),and more attention is being paid to the reduction of toxicity(in the Moonlight study)and the exploration of new treatment models(in the targeted combination immunotherapy:LEAP-015 study;in the immunotherapy combined with radiotherapy:Neo-PLANET study).This paper reviewed the progress of gastric cancer research in 2022,and provided ideas and suggestions for more accurate understanding of its pathogenesis,in-depth clinical translational research and formulation of clinical practice programs.

关 键 词：胃癌 发病机制 基础研究 靶向治疗 免疫治疗 

分 类 号：R735.2[医药卫生—肿瘤]