The treatment of metastasized gastroesophageal adenocarcinoma largely depends on molecular profiling based on immunohistochemical procedures. Therefore, the examination of HER2, PD-L1, and dMMR/MSI is recommended by the majority of clinical practice guidelines, as positive expression leads to different treatment approaches. Data from large phase-III trials and consequent approvals in various countries enable physicians to offer their patients several therapy options including immunotherapy, targeted therapy, or both combined with chemotherapy. The introduction of novel therapeutic targets such as CLDN18.2 leads to a more complex decision-making process as a significant number of patients show positive results for the co-expression of other biomarkers besides CLDN18.2. The aim of this review is to summarize the current biomarker landscape of patients with metastatic gastroesophageal tumors, its direct clinical impact on daily decision-making, and to evaluate current findings on biomarker co-expression. Furthermore, possible treatment strategies with multiple biomarker expression are discussed.
转移性胃食管腺癌的治疗在很大程度上依赖于基于免疫组织化学方法的分子谱分析。因此，大多数临床实践指南建议对HER2、PD-L1和dMMR/MSI进行检测，因为这些标志物的阳性表达会导致不同的治疗方案。来自大型III期试验的数据以及随后各国批准的疗法使医生能够为患者提供多种治疗选择，包括免疫治疗、靶向治疗或两者联合化疗。新型治疗靶点如CLDN18.2的引入使决策过程变得更加复杂，因为相当一部分患者除了CLDN18.2外，还表现出其他生物标志物共表达的阳性结果。本综述旨在总结当前转移性胃食管肿瘤患者的生物标志物概况，及其对日常临床决策的直接临床影响，并评估当前关于生物标志物共表达的研究发现。此外，本文还讨论了多种生物标志物表达下可能的治疗策略。
肿瘤(癌症)患者之家