2021版CSCO胃癌诊疗指南转移性胃癌更新解读

对于晚期或转移性胃癌患者，目前公认采取以全身抗肿瘤药物治疗为主的多学科综合治疗和全程多方位管理以延长患者生存时间和改善患者生存质量。中国临床肿瘤学会（CSCO）胃癌诊疗指南每年更新，融合国内外最新的临床研究进展，关注中国人群研究数据和贴近本国临床实践。2021版CSCO转移性胃癌诊疗指南更新主要围绕免疫治疗、抗HER2靶向治疗和胃癌支持治疗等方面展开。基于2020年晚期胃癌在免疫治疗取得重大突破，更新重点聚焦免疫治疗，2021版CSCO指南从新的临床证据出发，针对免疫治疗从一线到三线，如何选择不同的程序性死亡受体-1（programmed cell death 1，PD-1）单抗药物，不同的适用人群均作出了详细推荐及注释，以期规范免疫治疗在晚期胃癌中的应用。本文就2021版CSCO指南对免疫治疗、抗HER2靶向治疗和胃癌支持治疗等方面的更新作总结性的解读，概括性阐明2021版CSCO中反映的晚期转移性胃癌治疗的新进展。 

Interpretation of updated 2021 CSCO guidelines for the diagnosis and treatment of metastatic gastric cancer

Multidisciplinary comprehensive treatment and whole-process multi-directional management based on systemic antitumor drugs are generally adopted in patients with advanced or metastatic gastric cancer in order to prolong survival and improve the quality of life of patients. The Chinese Society of Clinical Oncology (CSCO) guidelines for the diagnosis and treatment of gastric cancer are updated every year. The guidelines integrate the latest advances in domestic and foreign clinical research and serve to guide domestic clinical practice. The updated 2021 CSCO Guidelines for the Diagnosis and Treatment of Metastatic Gastric Cancer mainly focused on immunotherapy, anti-human epidermal growth factor receptor 2 (anti-HER2)-targeted therapy, and supportive therapy. The updated guidelines focus on the major developments in immunotherapy for advanced gastric cancer in 2020. Detailed recommendations and notes were made on the clinical application of immunotherapy (from first-line to third-line treatment), choices of different programmed death 1 (PD-1) antibodies, and different applicable populations, so as to standardize the application of immunotherapy in advanced gastric cancer. This article summarizes the updates on immunotherapy, anti-HER2-targeted therapy, and supportive care for gastric cancer in the new CSCO guidelines, in order to generalize the new progress in the treatment of advanced metastatic gastric cancer reflected in the new CSCO guidelines.