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食管癌新辅助治疗中的靶向治疗

Targeted therapies in neoadjuvant treatment for gastroesophageal cancer.

作者信息

Freile Berenice, Rodriguez Andrés, Catani Greta, Bortz Marcos, Bruno Luisina, O'Connor Juan M, Esteso Federico

机构信息

Gastrointestinal Department, Clinical Oncology, Instituto Alexander Fleming, CABA 1426, Argentina.

出版信息

Ecancermedicalscience. 2025 Jun 3;19:1921. doi: 10.3332/ecancer.2025.1921. eCollection 2025.

Abstract

Gastroesophageal cancers are among the most prevalent cancers globally and represent the third leading cause of cancer-related mortality worldwide. Surgical resection remains the primary curative approach for localised and locally advanced stages, but its effectiveness is limited for locally advanced diseases, evidenced by a low 5-year survival rate of around 25%. High relapse rates post-surgery, particularly in Western populations, necessitate the use of neoadjuvant, adjuvant or perioperative strategies involving chemotherapy and radiation to improve surgical outcomes. Neoadjuvant chemoradiation therapy has demonstrated a significant improvement in overall survival. Recent advances have identified several target genes and pathways involved in the pathogenesis and progression of these cancers, leading to the development of targeted drugs, including immunotherapy, anti-HER-2 antibodies and anti-vascular endothelial growth factor receptor antibodies. These targeted therapies are emerging as promising interventions for better patient outcomes and personalised treatment approaches and, therefore, could eventually evolve into a novel therapeutic regimen for gastroesophageal cancer.

摘要

食管癌是全球最常见的癌症之一,是全球癌症相关死亡的第三大主要原因。手术切除仍然是局部和局部晚期阶段的主要治愈方法,但其对局部晚期疾病的有效性有限,5年生存率约为25%就证明了这一点。术后高复发率,尤其是在西方人群中,需要使用包括化疗和放疗在内的新辅助、辅助或围手术期策略来改善手术效果。新辅助放化疗已显示出总生存率的显著提高。最近的进展已经确定了几种与这些癌症的发病机制和进展有关的靶基因和途径,从而导致了靶向药物的开发,包括免疫疗法、抗HER-2抗体和抗血管内皮生长因子受体抗体。这些靶向治疗正成为有望改善患者预后和个性化治疗方法的干预措施,因此最终可能演变成一种新的食管癌治疗方案。

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