下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:Claudin18.2 in Advanced Gastric Cancer.
在全球范围内,第五大常见癌症和第四大癌症死亡原因是胃癌(GC)。
胃癌(GC)是全球第五常见癌症,也是癌症相关死亡的第四大原因。近期实体瘤临床试验纳入了具有可靶向基因改变、蛋白表达或特定免疫特征的患者。根据III期试验结果,对于胃癌或胃食管结合部(GEJ)癌,HER2阳性患者接受曲妥珠单抗联合一线化疗,以及接受雷莫西尤单抗联合二线紫杉醇,较单纯化疗均显著延长总生存期(OS)。近期,免疫检查点抑制剂(ICI)单药疗法已获批作为三线或后续治疗。CheckMate 649试验结果显示,HER2阴性患者一线接受化疗联合ICI较单纯化疗生存改善。相反,晚期GC患者接受全身化疗后的预后仍较差,尽管部分患者可能获得持久治疗应答并延长生存。近期,首创的嵌合免疫球蛋白G1单克隆抗体zolbetuximab成为GC治疗的一种新靶向疗法,可靶向并结合claudin 18亚型2(CLDN18.2)。全球III期试验显示,对于CLDN18.2阳性、HER2阴性GC患者,一线化疗中加入zolbetuximab可延长OS。本综述总结近期CLDN18.2靶向治疗临床试验。
Globally, the fifth most common cancer and the fourth leading cause of cancer-related mortality is gastric cancer (GC). Recent clinical trials on solid tumors enrolled patients who possess druggable genetic alterations, protein expression, and immune characteristics. In gastric or gastroesophageal junction (GEJ) cancers, trastuzumab combined with first-line chemotherapy in human epidermal growth factor receptor 2 (HER2)-positive patients and ramucirumab combined with second-line paclitaxel remarkably prolonged overall survival (OS) compared with chemotherapy alone, according to phase 3 trial results. Recently, immune checkpoint inhibitor (ICI) monotherapy was approved as third- or later-line treatment. Chemotherapy plus ICIs as first-line treatment exhibited improved survival compared with chemotherapy alone in HER2-negative patients according to Checkmate 649 trial results. Conversely, systemic chemotherapy prognosis remains poor. although some patients may achieve durable response to treatment and prolonged survival in advanced GC. Recently, a first-in-class, chimeric immunoglobulin G1 monoclonal antibody (zolbetuximab) that targets and binds to claudin 18 isoform 2 (CLDN18.2) has emerged as a new target therapy in GC treatment. Global phase trials revealed that the addition of zolbetuximab to first-line chemotherapy prolonged OS in CLDN18.2-positive and HER2-negative GC patients. This review summarizes recent clinical trials of CLDN18.2-targeted therapy.
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