Targeted therapies in gastric cancer treatment: where we are and where we are going
Summary Gastric cancer (GC) is one of the most common malignancies and a major cause of cancer-related deaths worldwide. Its incidence has significantly declined over the last few decades, probably due to the identification of specific etiologic agents such as Helicobacter pylori and other dietary and environmental risk factors. Nevertheless, most of the cases are unfortunately diagnosed at an advanced stage justifying median overall survival rates frequently not exceeding one year. Palliative combination chemotherapy usually represented by a platinum-based doublet is the mainstay of treatment in the metastatic setting. Adding a third drug such as an anthracycline or a taxane has been shown to improve response rate and provide limited survival benefits in fit selected patients. Unlike other tumors, the introduction of molecularly targeted drugs in the medical armamentarium for GC is relatively recent with trastuzumab and ultimately ramucirumab constituting the only agents approved to date. Recent advances in the understanding of GC biology have led to the development of novel targeted therapies holding the promise to further improve treatment outcomes. The aim of this paper is to review the main available data coming from clinical trials of targeted drugs and to describe some of the most interesting molecules in clinical development in GC. These include drugs targeting EGFR, angiogenesis, c-MET, FGFR2, mTOR and immune checkpoints.
Background: Insulin resistance, the primary mechanism of metabolic syndrome, promotes gastric carcinogenesis. Metabolic syndrome is associated with sarcopenia. We aimed to investigate the association between sarcopenia and gastric carcinogenesis, including precancerous conditions such as atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia.Methods: The study included adult patients who underwent gastroduodenoscopy at a checkup center. AG and IM were evaluated using endoscopy. Based on muscle mass, sarcopenia was defined as a skeletal muscle index
(University of Pennsylvania School of Medicine) Penn researchers are first to assess Helicobacter pylori infection and gastric cancer risk in Americans, certain demographics and ethnic groups.
Studies indicate that gastric cancer (GC) incidence has decreased, whereas signet ring cell carcinoma (SRC) incidence has increased. However, recent trends in GC incidence are unclear. We used our hospital can...
This study could provide usher in a new opportunity to understand the role of less studied gastric bacteria in the development of gastric diseases.
Authors: Figueroa-Protti L, Soto-Molinari R, Calderón-Osorno M, Mora J, Alpízar-Alpízar W Abstract Gastric cancer (GC) is one of the most important malignancies worldwide because of its high incidence and mortality. The very low survival rates are mainly related to late diagnosis and limited treatment options. GC is the final clinical outcome of a stepwise process that starts with a chronic and sustained inflammatory reaction mounted in response to Helicobacter pylori infection. The bacterium modulates innate and adaptive immunity presumably as part of the strategies to survive, which favors th...
ConclusionsThe longer the follow-up, the greater the risk of developing diffuse-type gastric cancer becomes in patients with mild-to-moderate gastric atrophy at baseline. Endoscopic surveillance should be continued beyond 10 years after cure ofH. pylori irrespective of the severity of gastric atrophy.
Conclusion: No new safety concerns were observed, and the effectiveness of vonoprazan-based triple therapy was confirmed in routine clinical practice. Trial registration: This study is registered at the Japan Pharmaceutical Information Center Clinical Trials Information (JapicCTI-153003). PMID: 31646920 [PubMed - as supplied by publisher]
Publication date: Available online 26 October 2019Source: Biochimica et Biophysica Acta (BBA) - BiomembranesAuthor(s): Patrick H. Hewitt, Ernest D. Pianim, Nicholas A. DiCesare, Casey Gray, Trung T. Leong, Kuriko Sakai, Jan V. Bernal, Shweta S. Shetty, Christopher S. MalarkeyAbstractGastric cancer is associated with high mortality and is preceded by an infection with Helicobacter pylori (H. pylori). H. pylori stimulates inflammation which involves the activation of Toll-like receptor 4 by lipopolysaccharide molecules from the H. pylori. This leads to chronic inflammation that can eventually lead to gastric cancer. Sox2 is ...
ConclusionOur result suggests that gastric cancer risk increases for men with BMI ≥ 27 kg/m2.