中国癌症杂志 ›› 2023, Vol. 33 ›› Issue (4): 303-314.doi: 10.19401/j.cnki.1007-3639.2023.04.001

• 专家述评 • 上一篇    下一篇

2022年度胃癌研究和诊疗新进展

蒋金玲1(), 周尘飞1,2, 王超1, 赵丽琴1, 吴珺玮1,2, 张俊1,2()   

  1. 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
  • 收稿日期:2023-02-17 修回日期:2023-04-17 出版日期:2023-04-30 发布日期:2023-05-15
  • 通信作者: 张俊(ORCID: 0000-0002-7973-8416),博士,主任医师,上海交通大学医学院附属瑞金医院肿瘤科主任。
  • 作者简介:蒋金玲(ORCID: 0000-0003-3365-6906),博士,主治医师。
    张俊,主任医师,教授,博士研究生导师,现任上海交通大学医学院附属瑞金医院肿瘤科主任、上海消化外科研究所研究员,是上海市医学领军人才和上海市优秀学术带头人。担任中华医学会肿瘤学分会胃癌学组副组长、全国生化检测标准化技术委员会委员、中国医师协会肿瘤学分会青年委员会副主任委员、中国抗癌协会肿瘤支持治疗专业委员会候任主任委员、上海市医学会肿瘤靶分子专科分会主任委员、上海市抗癌协会胃肠肿瘤专业委员会主任委员。承担国家自然科学基金5项,省部级项目多项;在SCI收录期刊上发表论著40余篇,执笔或参编《HER2阳性晚期胃癌诊疗中国专家共识》等专家共识10余部,主编或共同主编《肿瘤居家疗法》第1版及第2版、《结直肠癌规范化诊疗:国际进展与中国实践荟萃》等专著5部。多次获得国家级、省部级科技奖等。
  • 基金资助:
    国家自然科学基金(82273126);国家自然科学基金(81972707);国家自然科学基金(82103502);上海市卫生健康委协同创新集群计划(2020CXJQ03)

Advanced progress in research and diagnosis of gastric cancer in 2022

JIANG Jinling1(), ZHOU Chenfei1,2, WANG Chao1, ZHAO Liqin1, WU Junwei1,2, ZHANG Jun1,2()   

  1. 1. Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2. Department of Oncology, Wuxi Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Wuxi 214021, Jiangsu Province, China
  • Received:2023-02-17 Revised:2023-04-17 Published:2023-04-30 Online:2023-05-15
  • Contact: ZHANG Jun

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。

关键词: 胃癌, 发病机制, 基础研究, 靶向治疗, 免疫治疗

Abstract:

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.

Key words: Gastric cancer, Pathogenesis, Basic research, Targeted therapy, Immunotherapy

中图分类号: