Comparison and review of updated guidelines for advanced gastric cancer diagnosis and treatment in 2024:CSCO,NCCN and ESMO
10.19401/j.cnki.1007-3639.2025.02.009
- VernacularTitle:2024晚期胃癌诊疗指南更新对比与梳理:CSCO、NCCN和ESMO
- Author:
Yu LAN
1
;
Fenghua WANG
1
Author Information
1. 中山大学肿瘤防治中心肿瘤内科,广东 广州 510000
- Publication Type:Journal Article
- Keywords:
Gastric cancer;
Diagnosis and treatment guidelines;
CSCO;
NCCN;
EMSO
- From:
China Oncology
2025;35(2):219-227
- CountryChina
- Language:Chinese
-
Abstract:
Gastric cancer is a highly prevalent and aggressive malignancy worldwide,with generally poor prognosis.There are differences in epidemiology,clinicopathological characteristics,treatment modalities,and drug selection for gastric cancer between Eastern and Western populations.Recent advancements in targeted therapy and immunotherapy,the maturation of precision treatment concepts,and the promotion of multidisciplinary therapy have led to continuous updates in clinical research outcomes.Gastric cancer guidelines are annually updated to meet evolving diagnostic and therapeutic needs.This article compared the latest versions of three authoritative global gastric cancer guidelines[National Comprehensive Cancer Network(NCCN)clinical practice guidelines for gastric cancer 2024 version 5,European Society for Medical Oncology(ESMO)online guidelines for gastric cancer 2024,and Chinese Society of Clinical Oncology(CSCO)guidelines for gastric cancer diagnosis and treatment 2024],focusing on clinical treatment strategies for unresectable locally advanced or metastatic esophagogastric junction/gastric adenocarcinoma,and on the whole-process management and precise implementation guided by targets such as human epidermal growth factor receptor 2(HER2)expression,programmed cell death ligand 1(PD-L1)expression,mismatch repair(MMR)status,,and novel targets such as Claudin 18.2.Meanwhile,HER2-positive advanced gastric cancer has entered the era of full-line anti-HER2 treatment.Anti-HER2 antibody-drug conjugates(ADCs)has become a new option after first-line trastuzumab resistance.Immunotherapy combined with chemotherapy is regarded as a new standard for the first-line treatment of advanced gastric cancer.The diagnosis and treatment mode based on MMR status and PD-L1 expression promote the precision of immunotherapy.However,the detection of PD-L1 expression has difficulties in clinical promotion and implementation.The three guidelines in 2024 integrate the latest clinical study results,the new indication approval and the updated health care system.In particular,the CSCO gastric cancer guidelines are rewritten based on the rapid development of independently developed drugs in China and the approval of new indications.The three guidelines differ in the recommendation and adoption of targeted therapy and immunotherapy.This article showed different perspectives and focuses based on different guidelines,enriched the dimensions of clinical decision-making,helped the clinical adaptability of evidence-based guidelines to better enlightens clinical practice.
