The value of targeted drugs in advanced gastric cancer

If gastric cancer has been diagnosed, patients do not need to be discouraged. "Fighting cancer requires great courage and attention. Even if gastric cancer is not diagnosed in the first place, surgical removal of the lesion and new targeted drugs can well achieve safe, economical and effective chemotherapy."

With the introduction of capecitabine tablets, the world's first new type of intratumorally activated oral fluorouracil drug, into my country and its application in the treatment of advanced gastric cancer, patients no longer need intravenous intubation during chemotherapy, greatly reducing toxic reactions such as bone marrow suppression and hair loss.

As proven by large-scale international clinical trials, capecitabine tablets, as a new generation of oral chemotherapy drugs activated within tumors, have become a new choice for first-line treatment of advanced gastric cancer. At the same time, considering the total medical expenses such as the cost of the drug itself, the cost of administration, and the cost of dealing with side effects, oral chemotherapy drugs are more economical and affordable: for the same course of treatment, gastric cancer patients usually need to go to the hospital 22-27 times with traditional intravenous chemotherapy, while oral chemotherapy only requires 9-17 visits, saving 160 hours. A comparative survey showed that the cost of intravenous chemotherapy is 2.5 times that of oral chemotherapy drugs; and in terms of the cost of dealing with side effects, the former is nearly 5 times that of the latter.

New discovery: Gastric cancer also has "yin" and "yang"!

With a large number of clinical and basic researches on the prognostic factors of gastric cancer and the mechanism of action of targeted drugs, new discoveries have been made in the treatment of gastric cancer. About 22% of gastric cancer patients are HER2 (human epidermal growth factor receptor 2) positive.

As a proto-oncogene, HER2 overexpression is a dangerous signal and factor. Its status indicates that the patient's survival time is shorter, cancer patients are more likely to relapse, and the treatment effect is poor. HER2 overexpression in gastric cancer tissue is closely related to its high degree of lesion invasion and poor prognosis; therefore, Professor Liang Han recommends that gastric cancer patients should have a HER2 test.

Taking the ToGA randomized phase III clinical study aimed at studying the use of Herceptin to treat patients with inoperable locally advanced, recurrent and/or metastatic HER2-positive gastric cancer as an example, approximately 3,800 patients from multiple centers in Europe, Latin America and Asia (including multiple hospitals in Beijing, Shanghai, Wuhan, Nanjing and Suzhou in my country) underwent HER2-positive testing, and 594 HER2-positive gastric cancer patients were enrolled in the study.

This research, which brought a groundbreaking discovery to the treatment of gastric cancer, confirmed that HER2-positive gastric cancer patients achieved a very exciting result of 13.8 months of overall survival through trastuzumab (Herceptin) combined with chemotherapy. This exceeded the historical best result of 11.2 months created by the previous study, and reflected the advantages of implementing personalized treatment for gastric cancer under the guidance of screening drug targets. Other clinical trials of different designs have and are further proving the effectiveness and safety of anti-HER2 treatment combined with chemotherapy for gastric cancer with overexpression of HER2.

The results of the ToGA study mean that nearly 1/4 (about 100,000) of gastric cancer patients in my country may benefit from trastuzumab treatment, prolong their lives, and improve their quality of life, which will play a vital role in saving national and social health resources. Anti-HER2 therapy is changing the strategy and model of gastric cancer treatment, bringing new hope to gastric cancer patients, and will become a new option for gastric cancer treatment in the future.