Page 269 - EJMO-9-1

Eurasian Journal of Medicine and
Oncology
Combination strategies for gastric cancer

trials revealed the efficacy of regorafenib. Based on the In summary, the treatment of AGC is undergoing
results of phase II research, trastuzumab deruxtecan was constant evolution through innovative combinations
approved by the European Medicines Agency for treating of different therapy regimens. The combination of
HER2-positive patients. Studies have also found that nivolumab, ramucirumab, and paclitaxel has shown
baseline plasma levels of interleukin-8 (IL-8) and soluble potential efficacy and tolerability in different clinical
vascular cell adhesion molecule-1 (sVCAM-1) can serve contexts, bringing new hope to patients. Although the
as prognostic markers, predicting overall survival with sample size of current related studies is relatively small,
better forecasting performance. This means that baseline these preliminary results lay the foundation for further
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levels of IL-8 and sVCAM-1 in the plasma of patients with research. In the future, large-scale, multicenter trials will
AGC can be detected when using a combination therapy accurately determine the effectiveness and safety of these
of paclitaxel, ramucirumab, and nivolumab. For patients regimens, and comprehensively compare them with other
with higher baseline levels, this therapeutic regimen can treatment options, ultimately providing patients with more
be adopted with higher confidence. Elevated IL-6 levels optimized treatment combinations. Meanwhile, exploring
detected after 4 weeks of treatment may indicate that the the combination of TCM and modern therapies may bring
treatment regimen is having a positive effect. new hope for increasing patients’ survival probabilities and
The combination therapy of avelumab, paclitaxel, and elevating their living standards.
ramucirumab has demonstrated promising effectiveness Conflict of interest
as a second-line treatment of metastatic esophagogastric
adenocarcinoma. In cancer treatment, patient tolerance to The authors declare they have no competing interests
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treatment is a crucial element that influences the feasibility
and compliance of treatment plans. The combination Author contributions
therapy demonstrated good tolerability and no unexpected Conceptualization: Xianbin Kong
toxicity, making it more likely for patients to successfully Writing–original draft: Jiajing Zheng
complete the entire treatment process and ensure treatment Writing–review & editing: Xianbin Kong
effectiveness. For patients with high PD-L1 CPS, low levels
of free DNA, and abundant T cell banks, this combination References
therapy may be an ideal second-line treatment option. In 1. Guan WL, He Y, Xu RH. Gastric cancer treatment:
this study, the combined approach demonstrated good Recent progress and future perspectives. J Hematol Oncol.
survival rates. The 6-month overall survival rate stood at 2023;16(1):57.
71.2%, whereas the median value of overall survival was doi: 10.1186/s13045-023-01451-3
10.6 months.
2. Smyth EC, Nilsson M, Grabsch HI, van Grieken NC,
It has been shown that traditional Chinese Lordick F. Gastric cancer. Lancet. 2020;396(10251):635-648.
medicine (TCM) poses significant inhibitory effects on
gastrointestinal tumors. Research has shown that TCM can doi: 10.1016/s0140-6736(20)31288-5
impede the inhibitory influence that carcinogens exert on 3. Akbas S, Alan O, Kuvvet BB, Lacin S, Köylü B, Selcukbiricik F.
normal cells and also eliminate cells with a high propensity Nivolumab, ramucirumab and paclitaxel combination as
for metastasis, thereby hampering tumor metastasis. second line therapy for advanced stage gastric cancer. EJMO.
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The combination therapy of Western medicine and TCM 2024;8(4):488-495.
shows broad prospects. A study on AGC showed that the doi: 10.14744/ejmo.2024.40834
combination of Chinese herbs such as astragalus, large- 4. Nakajima TE, Kadowaki S, Minashi K, et al. Multicenter
head atractylodes, Chinese angelica, codonopsis, liquorice, phase I/II study of nivolumab combined with paclitaxel
poria, and tangerine peel with oxaliplatin chemotherapy can plus ramucirumab as second-line treatment in patients with
improve the objective response rate and disease control rate, advanced gastric cancer. Clin Cancer Res. 2021;27(4):1029-1036.
and reduce the side effects of chemotherapy. Another study doi: 10.1158/1078-0432.Ccr-20-3559
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found that the combination of Qizhen decoction and PD-1
inhibitors enhanced the anti-tumor effect. The mechanism 5. Depotte L, Palle J, Rasola C, et al. New developments and
is to increase the abundance of Akkermansia in the gut standard of care in the management of advanced gastric
microbiota, promote the maturation of dendritic cells, and cancer. Clin Res Hepatol Gastroenterol. 2024;48(1):102245.
activate the IL-12/JAK2/STAT4 pathway. Consequently, the doi: 10.1016/j.clinre.2023.102245
activation of effector T cells is enhanced, contributing to a 6. Izawa N, Ohta S, Kadowaki S, et al. 104P Angiogenesis-
better therapeutic effect on colorectal cancer. 10 related factors and clinical outcomes in combination

Volume 9 Issue 1 (2025) 261 doi: 10.36922/ejmo.8594