胃癌

正在研究的化疗药物

S-1（替加氟、5-氯-2,4-二羟基吡啶、氧嗪酸钾）是一种第四代氟尿嘧啶类药物，在日本广泛使用；[73]Boku N, Yamamoto S, Fukuda H, et al; Gastrointestinal Oncology Study Group of the Japan Clinical Oncology Group. Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol. 2009 Nov;10(11):1063-9.http://www.ncbi.nlm.nih.gov/pubmed/19818685?tool=bestpractice.com 但在美国等部分国家/地区，该药却未获得使用批准。在其他国家的患者中，已对 S-1 加顺铂（联合使用）进行了研究，但与氟尿嘧啶/顺铂相比，该方案未延长总生存期。[74]Ajani JA, Rodriguez W, Bodoky G, et al. Multicenter phase III comparison of cisplatin/S-1 with cisplatin/infusional fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: the FLAGS trial. J Clin Oncol. 2010 Mar 20;28(9):1547-53.http://ascopubs.org/doi/full/10.1200/jco.2009.25.4706http://www.ncbi.nlm.nih.gov/pubmed/20159816?tool=bestpractice.com 在晚期胃癌一线治疗研究 (First-Line Advanced Gastric Cancer Study, FLAGS) 中，相较于顺铂/氟尿嘧啶，采用顺铂/S-1 治疗转移性弥漫型胃癌并未延长患者的总生存期。[75]Ajani JA, Buyse M, Lichinitser M, et al. Combination of cisplatin/S-1 in the treatment of patients with advanced gastric or gastroesophageal adenocarcinoma: results of noninferiority and safety analyses compared with cisplatin/5-fluorouracil in the First-Line Advanced Gastric Cancer Study. Eur J Cancer. 2013 Nov;49(17):3616-24.http://www.ncbi.nlm.nih.gov/pubmed/23899532?tool=bestpractice.com 来自 INTEGRATE（瑞戈非尼 [regorafenib] 治疗难治性晚期胃食管癌的 II 期随机、双盲、安慰剂对照研究）临床试验的结果显示，瑞戈非尼有望成为胃癌患者的二线治疗药物。[76]Pavlakis N, Sjoquist KM, Martin AJ, et al. Regorafenib for the treatment of advanced gastric cancer (INTEGRATE): a multinational placebo-controlled phase II trial. J Clin Oncol. 2016 Aug 10;34(23):2728-35.http://ascopubs.org/doi/full/10.1200/JCO.2015.65.1901http://www.ncbi.nlm.nih.gov/pubmed/27325864?tool=bestpractice.com 一项Ⅲ期试验正在规划中。