On September 26, some media reported that Zhang Pengyi, a well-known director in Taiwan, died of stomach cancer on the 24th at the age of 80, and many descendants in the circle mourned in grief.
It is reported that Zhang Pengyi is very talented in shooting martial arts action films, and after joining Hong Kong Shaw Film Company, he directed many films based on Gu Long's novels, including "Sword Soul" and "Chu Liuxiang" series, etc. He is also known as the "founding father of Taiwanese martial arts films".
In fact, director Zhang Pengyi is not the only celebrity who died of stomach cancer this year. In March this year, the Hong Kong Film Awards Best Supporting Actor, 66-year-old Hong Kong film star Liao Qizhi, who participated in films such as "Infernal Affairs II", "Kill the Wolf", "Bomb Disposal Expert", "Peerless", "Point Five Steps" and other films, also died of stomach cancer.
In less than a year, two celebrities have died of stomach cancer, which also supports the high incidence and mortality of gastric cancer.
In addition to our lamentations, we can't help but think about the face of advanced stomach cancer, what new drugs (targeted, immune and other drugs) and new technologies for stomach cancer can significantly prolong survival and bring more clinical benefits? Today's cancer-free home Xiaobian will comb it out for everyone, for reference only!
Targeted drugs
Traditional treatments for advanced gastric cancer include surgery, radiation therapy and chemotherapy, but the cure rate of advanced gastric cancer surgery is low, and the efficacy of chemoradiation is not good. With the rise of targeted therapy, the research on the molecular mechanism of gastric cancer occurrence and development has continued to deepen, and targeted therapy for gastric cancer has emerged. The higher efficacy and lower side effects of targeted drugs have brought dawn to the treatment of advanced gastric cancer.
At present, the targets for gastric cancer mainly include EGFR, HER-2, VEGF, VEGFR, mTOc-MET, HGF and so on.
With the emergence of more and more anti-cancer drugs, it has become possible to control tumor progression through long-term treatment and turn incurable diseases into "chronic diseases".
Facing stomach cancer, the "domestic version of remolosumab" gintuximab is ready to go!
Target: VEGFR
As the body develops and grows, it causes new blood vessels to supply blood to all cells, a process called angiogenesis. When new blood vessels provide oxygen and nutrients to cancer cells, they contribute to the growth and spread of cancer cells.
Angiogenesis inhibitors help stop or slow the growth or spread of tumors by preventing them from making new blood vessels, causing tumors to die or stop growing because they cannot get the oxygen and nutrients they need. Inhibitors work by blocking the vascular endothelial growth factor (VEGF) receptors of cancer cells.
Ramucirumab (Cyramza®) is a humanized monoclonal targeted antibody that specifically blocks vascular endothelial growth factor receptor 2 (VEGFR2) and downstream angiogenesis-related pathways, and is an anti-angiogenesis-targeted drug.
The drug was approved by the FDA in 2014 based on two key clinical trials as the first treatment for patients with advanced gastric cancer after chemotherapy.
Principle of action: antagonist of vascular endothelial cell growth factor (VEGF) receptor 2, can specifically bind to VEGF receptor 2 and block the coordination of VEGF ligands, VEGF-A, VEGF-C and VEGF-D.
Brand name: Cyramza
Indications: Gastric adenocarcinoma or adenocarcinoma at the junction of the gastroesophagus
Applicable population: Suitable for stomach cancer patients whose condition worsens after certain chemotherapy. May be used alone or in combination with paclitaxel.
Dosage and usage: Once every 2 weeks at 8 mg/kg body weight, injected into a vein within 60 minutes.
Side effects: hypertension, diarrhea (monotherapy), fatigue, neutropenia, epistaxis (combination).
Fortunately, China's pharmaceutical companies have conducted in-depth research on the same target of remolosumab human vascular endothelial growth factor receptor 2 (VEGFR2/KDR) and developed a "domestic version of remolosumab" (Me-Too product) gintuximab to help the survival of gastric cancer patients!
At present, the clinical study of .b/II. of jintuximab in China has been carried out, and it is planned to recruit 76 patients with advanced gastric and gastroesophageal junction adenocarcinoma to challenge the second-line treatment plan!
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Patients with histologically diagnosed advanced or metastatic gastric or gastric-duct-conjugated adenocarcinoma who have previously received platinum-containing plus fluorouracil-based chemotherapy or within 3 months after the end of treatment, and have not received anti-angiogenic drugs or paclitaxel.
Disease control rate of 73%, new hope for advanced stomach cancer! CAR-T Therapy CT041 amazes the world
At the annual meeting of the European Society of Oncology (ESMO) held from September 16 to 21, CT041, an autologous CAR-T candidate product developed by Corgy Pharmaceuticals, demonstrated its outstanding efficacy in digestive system tumors.
Claudin18.2 (CLDN18.2) is a gastric-specific membrane protein that is considered a potential therapeutic target for gastric cancer and other cancer types. Based on this, Chinese researchers developed the world's first CAR-T cell targeting Claudin 18.2.
As of April 8, 2021, 37 patients with advanced gastrointestinal tumors with CLDN18.2 positive expression, including 28 cases of gastric cancer/gastroesophageal conjugate cancer, 5 cases of pancreatic cancer and 4 other types of solid tumors, about 84% of patients have received at least 2-line treatment in the past, and the median number of metastatic organs is 3.
The research data is quite eye-catching!
1. Total efficacy: the objective response rate of all patients reached 48.6%, and the disease control rate reached 73%; the total objective response rate of all patients with gastric cancer was 57.1%.
2. Gastric cancer patients who have previously received at least 2-line treatment failure: the objective response rate is 61.1%, and the disease control rate is 83.3%.
3.28 cases of gastric cancer/gastroesophageal junction carcinoma subgroup: in patients with previous PD-(L)1 inhibitor therapy failure, poor prognosis such as peritoneal metastases, and indolescence cell carcinoma, the objective response rate was maintained at 50% or more.
4. Safety: CT041 is generally well tolerated, and no treatment-related deaths or immune cell therapy-related neurotoxic syndromes (ICANS) have occurred.
In addition to CT041 currently undergoing clinical trials, another CAR-T cell preparation called LCAR-C18S, called LCAR-C18S, for recurrent or metastatic advanced gastric adenocarcinoma (including gastroesophageal-conjugate adenocarcinoma) that has previously undergone total gastrectomy/gastrectomy, is also being recruited in the clinic.
As the first CAR-T cell in the world to target Claudin 18.2, CT041 has emerged as early as the 2019 ASCO Annual Meeting, when the total objective response rate of 33.3% has already amazed the world, and now the more significant curative effect is undoubtedly the icing on the cake! The clinical data shows a good treatment prospect for digestive system tumors!
Striving for the target "high ground", the new drug Zolbetuximab benefits more than half of patients!
Zolbetuximab (IMAB362) is a class of monoclonal antibody drugs against the Claudin 18.2 target.
In the data published at the 2016 ASCO conference, patients with locally advanced or metastatic gastric cancer treated with Zolbetuximab + CAPOX chemotherapy regimen had a median progression-free survival of 7.9 months and a median overall survival of 13.2 months; significantly longer than 4.8 months and 8.4 months with CAPOX chemotherapy regimen alone.
In the data from the Phase II study published in 2019, it was also confirmed that Zolbetuximab had a clinical benefit rate of 23% in the treatment of patients with advanced gastric cancer or carcinoma at the gastroesophageal junction or esophageal adenocarcinoma.
At present, Zolbetuximab has been approved by the FDA for Phase III clinical trials, and it is expected to obtain more valuable large-scale efficacy data as soon as possible. Recently, Zolbetuximab's clinical trial for patients with locally advanced unresectable or metastatic gastric and gastroesophageal junction adenocarcinoma was approved by the State Drug Administration and officially began recruiting patients in China. If you want to know the specific enrollment criteria, please contact the Cancer-Free Home Medical Department.
THE GOSPEL OF MET AMPLIFIED GASTRIC CANCER PATIENTS, SINOPHARM LIGHT SIVOTINIB RESEARCH STARTED!
On July 28, a phase II clinical trial of sivatinib for the treatment of MET amplified gastric cancer patients led by Professor Shen Lin of Peking University Cancer Hospital was officially launched. As early as June 22, China's State Drug Administration (NMPA) has officially approved the listing of cevotinib for the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EXON-skipping mutations in MET14.
As the first approved highly selective MET inhibitor in China, sivotinib has ushered in a new era of MET targeted therapy for cancer in China.
MET amplification is relatively rare in gastrointestinal tumors, occurring in about 0% to 5%. However, due to the huge base of stomach cancer patients in China, according to the latest global cancer data, the number of new cases of gastric cancer in China in 2020 is nearly 480,000, and the number of deaths is about 370,000, so MET inhibitors are still promising in the field of gastric cancer.
The good news is that the current clinical trial project of sivatinib for the treatment of gastric cancer is under clinical recruitment, and interested parties can consult the Cancer-Free Home Medical Department for a detailed assessment of the condition.
80-year-old Taiwanese famous director Zhang Pengyi died of stomach cancer, and new drugs and new technologies for advanced gastric cancer were assembled! How to make the survival longer?
Immune drugs
Various immunotherapy drugs represented by PD-1/PD-L1 inhibitors have "saving" significance when the efficacy of gastric cancer chemotherapy has entered a bottleneck and the development of targeted therapy is difficult to keep up with the needs of patients.
The first immunotherapy drug approved by the FDA for gastric cancer: pyromab
The FDA approved pembizumab for patients with advanced gastric cancer who have received at least 2 treatments, including chemotherapy, for the treatment of patients with recurrent locally advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinomas whose tumors express PD-L1 [Comprehensive Positive Score (CPS) ≥1], as determined by FDA-approved tests. Progression after chemotherapy including fluoropyrimidine and platinum, or two- or multi-line therapy with HER2/neu targeted therapy. In addition, genetic test results MSI-H are also indicated for patients with stomach cancer.
Principle of action: PD-1 inhibitors
Brand Name: Keytruda (K Drug)
Who is suitable for: PD-L1 protein and disease worsens during or after two or more treatments (e.g., during or after fluorouracil and platinum chemotherapy)
Dosage and Usage: Use every three weeks for 2 mg/kg body weight, 30 minutes for intravenous infusion
Side effects: joint/back pain, swelling of the body or face, skin color changes, extreme tiredness or lack of vitality, fever, nausea, vomiting
The control rate of gastric cancer in the third line of Pyomumab + chemotherapy is 48%
At the 2021 American Society of Clinical Oncology Symposium on Gastrointestinal Oncology (ASCO GI) Cancer Conference, researchers unveiled the efficacy of pimumab plus levatinib in the treatment of patients with a variety of treated solid tumors. The results of the subgroup showed that pembromab + levatinib achieved a certain efficacy in the treatment of gastric cancer at the posterior or terminal line.
A total of 31 patients with gastric cancer were included, and by the time of the median follow-up of 7 months, 39% of the patients were thrown to receive treatment, and the overall response rate of all patients was 10%, the disease control rate was 48%, and the median progression-free survival was 2.5 months and the median overall survival was 5.9 months.
The patients included in the trial were all those who had already received 2-line therapy, and the overall efficacy of Pymbrosemumab + levatinib was encouraging. The number of patients recruited in the clinical trial's gastric cancer cohort has now expanded to 100, and the researchers hope to observe more stable efficacy from larger samples.
The editor has something to say
Because the early symptoms of stomach cancer are not obvious, so patients are generally found late, coupled with high heterogeneity, the difference is particularly large, in addition, the stomach is an important digestive organ for storing and digesting things, each patient's physical state is different, the tumor grows fast, metastasizes quickly, so the treatment of gastric cancer is difficult.
Therefore, in the face of the vicious enemy of stomach cancer, patients should try to target, immunity and other new drugs, new technologies for treatment, in order to significantly prolong survival and obtain more clinical benefits.