How to choose targeted therapy for gastric cancer patients?

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Gastric cancer has no good targeted drugs in the past, all relying on cytotoxic drugs that “kill the enemy by a thousand and damage by 800”, which has large side effects. In recent years, with the continuous progress of precision therapy, gastric cancer patients can also benefit from small side effects and accurately guide targeted therapy of tumor cells.

In recent years, many domestic and foreign research progress has also confirmed the importance of targeted drugs in the first-line treatment of HER2-positive gastric cancer, which can not only prolong the survival of patients with HER2-positive advanced gastric cancer, but also effectively improve the quality of life of advanced cancer patients.

What is HER2?

HER2 refers to human epidermal growth factor receptor 2, which can be simply understood as a protein called HER2. If a cancer cell expresses too much HER2 protein, it is said to be HER2 positive, and the patient’s cancer cell grows faster and is more aggressive, and the condition of this type of patient is relatively more likely to deteriorate. But it is gratifying that it is precisely because of the high expression of the protein HER2 that they are like tags on the surface of cancer cells, providing effective targets for precise treatment of targeted drugs.

According to ToGA big data research, about 16% of gastric cancer patients are HER2 positive, which means that one out of every 6 or so gastric cancer patients is HER2 positive.

Why test Her2 gene?

Due to the generally low awareness of HER2 testing in patients with gastric cancer in China and the lack of clear treatment guidelines, the overall rate of HER2 testing is low. Unfortunately, the rate of HER2 positive detection in foreign countries is around 20%, while in China only 5%, which means that many patients could have used targeted drug therapy.

Due to the strong heterogeneity of gastric cancer and poor sensitivity to chemotherapy and targeted drugs, it is a tumor that requires high personalized treatment. The main points of the second edition of the “Chinese Expert Consensus for Molecular Targeted Therapy of HER2-positive Advanced Gastric Cancer” and “NCCN Digestive System Tumor Clinical Practice Guidelines” (“NCCN Guidelines” Chinese version.) Clearly states that: every patient with pathological diagnosis of gastric cancer needs to undergo HER2 testing, and points out that repeated biopsies are necessary.

The sooner a patient with gastric cancer knows the positive status of HER2, the sooner they can receive precise treatment, which will benefit more patients. At present, the number of targeted therapies approved for gastric cancer worldwide is relatively small. Herceptin, Ramucirumab and Apatinib have been approved for marketing.

How to detect Her2 in patients with gastric cancer?

There are two detection methods, one commonly used in the world is immunohistochemistry, and the other is genetic detection.

The two methods are technically complementary, especially if both methods are positive, then the indication of patients receiving molecular targeted therapy is stronger.

The low positive rate of HER2 reported in China is also related to the detection level and technology on the other hand.

Global Oncologist Network recommends that patients with gastric cancer:

1. At least accept the detection of gastric cancer related genes.

2. It is best to receive a full-gene cancer test (hundreds of related genes) at a time, so that you can get more drug-related information and clinical trial information about treatment.

3. Accept the testing by the US and domestic genetic testing institutions recommended by the Global Oncologist Network to avoid incorrect testing results due to technology and quality control.

There are hundreds of domestic genetic testing institutions, and the quality varies. Global Oncologist Network recommends that patients choose domestic testing institutions or send them directly to American hospitals or American genetic testing companies for testing.

Due to work needs, the Global Oncologist Network will receive the genetic test report sent by the patient every day, and hope that the experts will interpret it. These genetic test reports are individually from large domestic companies, and most of the reports are produced by small companies around the world. From the analysis of the content of the report, most companies can only rely on public data for interpretation of test data, recommend targeted drugs, and fail to carry out individual analysis according to the specific conditions of patients. Even, the recommended clinical trials are also from clinical trials official website clinical trials Randomly select some on .gov. Such a test report cannot fully interpret the significance of the patient’s genetic test results, nor can it specify an individualized treatment plan for the patient, which wastes cancer patients’ lives and delays treatment time.

Global oncologist network medical experts solemnly remind cancer patients that if they decide to do genetic testing, they must choose a genetic testing company, such as F company has the largest laboratory of genetic testing in Asia, with a data analysis team of nearly 100 people. Different levels of genetic testing companies are very different from testing equipment, data analysis, expert team, clinical matching and other aspects.

For patients with better economic conditions, we will also recommend the first choice of genetic testing in the United States. This company is the world ’s most research institution, updating genetic research results, targeted drugs and clinical trials at any time.

A high-quality whole genome sequencing can benefit patients in the whole process of cancer treatment! Every year, the US FDA has approved new drugs and clinical trials for new targets. These treatment opportunities can only be obtained through the most testing institutions.

In short, if you are diagnosed with gastric cancer, don’t be frustrated. Remember to detect the level of HER2 expression. There is a 20% probability that gastric cancer patients can use specific drugs (targeted drugs).

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