Early switch maintenance in gastric cancer: who benefits most?

First-line treatments have historically relied on fluoropyrimidine and platinum agents, but more recent approaches incorporate biomarker-guided targeted therapies, including those based on PD-L1 combined positive score, mismatch repair status or microsatellite instability, and claudin-18.2 expressio...

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Veröffentlicht in:The lancet oncology 2024-12, Vol.25 (12), p.1508-1509
Hauptverfasser: Sakakida, Tomoki, Kadowaki, Shigenori
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creator Sakakida, Tomoki
Kadowaki, Shigenori
description First-line treatments have historically relied on fluoropyrimidine and platinum agents, but more recent approaches incorporate biomarker-guided targeted therapies, including those based on PD-L1 combined positive score, mismatch repair status or microsatellite instability, and claudin-18.2 expression. Paclitaxel plus ramucirumab has gained recognition as an effective second-line therapy.6 Additionally, a systematic review of 25 phase 3 trials confirmed a strong association between the rate of subsequent chemotherapy and overall survival improvements in gastric cancer.7 Collectively, these findings underscore the critical importance of timely treatment transitions to optimise survival. In the control group, the overall response rate was 16% with ongoing chemotherapy, whereas 32% showed disease progression.1 The switch maintenance group showed an overall response rate (19%) that was similar to the control group but only 9% had progressive disease; disease control was achieved by 85% of individuals who received switch maintenance therapy.
doi_str_mv 10.1016/S1470-2045(24)00659-4
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source Elsevier ScienceDirect Journals
subjects Biomarkers
Cancer therapies
Chemotherapy
Disease control
Gastric cancer
Medical prognosis
Microsatellite instability
Mismatch repair
Paclitaxel
Patients
PD-L1 protein
Response rates
Survival
title Early switch maintenance in gastric cancer: who benefits most?
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