Gastric cancer is growing
Gastric cancer remains one of the most common and deadly cancers worldwide, especially among older males. Based on GLOBOCAN 2018 data, stomach cancer is the 5th most common neoplasm and the 3rd most deadly cancer, with an estimated 783,000 deaths in 2018. Gastric cancer incidence and mortality are highly variable by region and highly dependent on diet and Helicobacter pylori infection. While strides in preventing and treating H. pylori infection have decreased the overall incidence of gastric cancer, they have also contributed to an increase in the incidence of cardia gastric cancer, a rare subtype of the neoplasm that has grown 7-fold in the past decades. A better understanding of the etiology and risk factors of the disease can help reach a consensus in approaching H. pylori infection. Dietary modification, smoking cessation, and exercise hold promise in preventing gastric cancer, while genetic testing is enabling earlier diagnosis and thus greater survival.
There are new gastric cancer drugs in 2020. There is a high incidence of gastric cancer in the world and its growing every year. The detection rate of patients with early gastric cancer is only about 5% -10%. Most patients are found to be in the middle or late stage because the early stage of gastric cancer is not obvious symptom.
However, gastric cancer is not an incurable disease. With the rapid progress of targeted therapy and immunotherapy, gastric cancer patients want to achieve long-term survival is no longer a problem. In addition to surgery and radiotherapy, drug therapy includes chemotherapy, targeted therapy, and immunotherapy.
Chemotherapy drugs for gastric cancer
Chemotherapy can be used to treat gastric cancer in different ways:
Many chemotherapy drugs can be used to treat gastric cancer, including:
5-FU (fluorouracil) is usually combined with formyltetrahydrofolate (folate)
6-Capecitabine (Xeloda®)
Carboplatin
Cisplatin
Docetaxel (Tassodi®)
Epirubicin (Ellence ®)
Irinotecan (Capto®)
Oxaliplatin (Losadine®)
Paclitaxel (Taxol®)
Gastric cancer chemotherapy drugs are usually given in a combination of drugs, including:
ECF (epirubicin, cisplatin and 5-FU) can be given before and after surgery
Docetaxel or paclitaxel plus 5-FU or capecitabine, combined with radiotherapy as a pre-operative treatment
Cisplatin plus 5-FU or capecitabine, combined with radiotherapy as a pre-operative treatment
Paclitaxel and carboplatin combined radiotherapy as preoperative treatment
Gastric cancer targeted drugs
HER2
Approximately 20% of patients express HER2 protein that promotes cancer growth, and inhibitors targeting Her 2 protein prevent human epidermal growth factor from attaching to Her2 by attaching themselves to Her2, thereby blocking cancer cell growth. It can be treated as a single drug, or in combination with several anti-HER2 targeted drugs, or in combination with chemotherapy drugs.
Trastuzumab (trastuzumab, Herceptin)
Trastuzumab (Herceptin) is a human monoclonal antibody that targets the HER2 protein. Chemotherapy with trastuzumab can help patients with advanced HER2-positive gastric cancer have a longer lifespan than chemotherapy alone.
Ontruzant (trastuzumab-dttb)
On January 18, 2019, the US FDA approved Samsung Bioepis ’Ontruzant (trastuzumab-dttb), a biosimilar of trastuzumab (trastuzumab) for the treatment of HER2 Positive breast cancer and HER2 overexpressed gastric cancer.
Tip: Before using the drug, please organize the test to determine the expression of HER2 protein. You can call 400-626-9916 to consult about genetic testing.
VEGFR
As the body develops and grows, it makes new blood vessels supply blood to all cells, a process called angiogenesis. When new blood vessels provide oxygen and nutrients to cancer cells, they help the growth and spread of cancer cells.
Angiogenesis inhibitors help prevent or slow the growth or spread of tumors by preventing tumors from making new blood vessels, causing tumors to die or stop growing because they cannot obtain the oxygen and nutrients they need. Inhibitors work by blocking vascular endothelial growth factor (VEGF) receptors in cancer cells.
Ramucirumab (Remolucumab, Cyramza®)
Ramucirumab is a monoclonal antibody that binds to the VEGF receptor and can help slow or stop the growth and spread of cancer. In 2014, the drug was approved for the treatment of gastric cancer and gastroesophageal junction cancer, but it is not currently available in China.
Gastric cancer immunotherapy
Immunotherapy aims to enhance the natural ability of the patient’s immune system to fight cancer. Immunotherapy does not directly target cancer cells in the human body, but trains a person’s natural immune system to recognize cancer cells and selectively target and kill them.
Pembrolizumab (Pembrolizumab, Keytruda)
FDA approves pembrolizumab for patients with advanced gastric cancer who have received at least 2 treatments (including chemotherapy) for the treatment of patients with recurrent locally advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma, whose tumor expression PD-L1 [Comprehensive Positive Score (CPS) ≥1], determined by a test approved by the FDA. Progressed after two or more lines of chemotherapy including fluoropyrimidine and platinum, or HER2 / neu targeted therapy. In addition, genetic test results of MSI-H are also applicable to gastric cancer patients.
