演題抄録

International Session

開催概要
開催回
第54回・2016年・横浜
 

Gastric cancer: Year in review in Asia

演題番号 : IS3-3

[筆頭演者]
Chung Hyun Cheol:1,2 

1:Yonsei Cancer Center, Yonsei University College of Medicine, Korea・Department of Internal Medicine・Division of Medical Oncology、2:Song-Dang Institute for Cancer Research

 

During the last 10 years, many progresses in advanced gastric cancer made strong evidences in survival prolongation and quality care of palliative chemotherapy comparing to best supportive care. This consensus includes doublet regimen in the first-line treatment in Asia comparing to triplet regimen in Western countries, and clinical rationale for the second-line and third-line chemotherapy. As a first-line, platinum or 5-fluorourail-based regimen is the golden standard, while paclitaxel is the treatment of choice as a second-line. Even if paclitaxel plus ramucirumab is approved as the second-line regimen, this regimen is not used as a routine practice due to reimbursement issue of ramucirumab. For HER2 positive patients, since XP/FP plus trastuzumab was approved as a standard treatment, there have been no data for the better combination regimen as a first-line or second-line for the failures. Unfortunately GATSBY trial could not showed the superiority of T-DM-1 over paclitaxel as a second-line treatment even if it has a good tolerability.
Last year, there has been a break out in immune-oncology treatment. Many trials are being done in first-line, second-line and third-line treatment designs, combination designs with chemotherapy or immune-oncology agents, head-to-head designs between immune-oncology agent and chemotherapy, maintenance treatment after induction of first-line treatment. As more targeted agents are being developed with potential efficacy and tolerable toxicity pattern and more knowledge of genomics are being gathered, single drug and multi-target, multi-drug and multi-target trials are being tried very rapidly. In the basket trial, gastric cancer is enrolled as a separate cohort or multi-drugs are being tested in gastric cancer as an umbrella design. During the last year, genome knowledge-based clinical trial, trial with immune-oncology agent and targeted agent were the key words in gastric cancer. New trials and finding will be discussed in detail.

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