lenvatinib联合免疫治疗与化疗 在晚期胃癌二线治疗中的研究进展

王 志立, 姬发 祥*, 李 豪
青海大学附属医院肿瘤内科一病区

摘要


晚期胃癌的治疗面临着显著的挑战，传统的化疗方案往往疗效有限且伴随明显的毒副作用。随着精准治疗
时代的到来，靶向药物与免疫治疗的联合应用为晚期胃癌患者提供了新的治疗机遇。lenvatinib作为一种多靶点酪氨
酸激酶抑制剂，能够靶向VEGFR1-3、FGFR1-4、PDGFRα、KIT和RET等多个关键信号通路，已在肝癌和肾癌
等多种实体瘤中展现出显著的抗肿瘤活性。其与免疫治疗的协同作用机制包括改善肿瘤血管异常状态、降低免疫抑
制功能以及增强免疫检查点抑制剂的敏感性。此外，化疗药物通过直接杀伤肿瘤细胞及重塑免疫微环境等机制，增
强了治疗的整体效果。本文系统地综述了lenvatinib联合PD-1抑制剂及化疗在晚期胃癌二线治疗中的最新临床研究
数据，重点分析了其客观缓解率、无进展生存期和总生存期等关键疗效指标，以及治疗相关不良事件的发生率和处理
策略。同时，探讨了基于生物标志物的精准治疗策略、耐药机制及未来的研究方向，以期为临床决策提供循证依据。

关键词


晚期胃癌；lenvatinib；靶向药物；免疫治疗；化疗；精准治疗

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参考


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