CAJ | 학술논문

　　目前对胃癌中人表皮生长因子受体2（HER2）的预测价值存有争议。当前的治疗指南已经把检测胃癌中HER2状态作为标准化操作。最近，在治疗HER2阳性进展期胃癌中，曲妥珠单抗已经成为一线靶向治疗用药，而原发与继发性药物抵抗则成为主要问题，需要新的治疗策略来克服这种抵抗。许多HER2阳性进展期胃癌患者在接受曲妥珠单抗治疗后都出现疾病进展，必须接受二线方案治疗。新的靶向药物，诸如酪氨酸激酶抑制剂（TKI）拉帕替尼、哺乳动物雷帕霉素靶蛋白（mTOR）通路抑制剂依维莫司、热休克蛋白90（HSP90）抑制剂AUY922、HER二聚化抑制剂帕妥珠单抗以及抗体-药物偶联物曲妥珠单抗-emtansine（T-DM1），在以曲妥珠单抗为基础的一线治疗失败时可以成为二线治疗用药。
　　목전대위암중인표피생장인자수체2（HER2）적예측개치존유쟁의。당전적치료지남이경파검측위암중HER2상태작위표준화조작。최근，재치료HER2양성진전기위암중，곡타주단항이경성위일선파향치료용약，이원발여계발성약물저항칙성위주요문제，수요신적치료책략래극복저충저항。허다HER2양성진전기위암환자재접수곡타주단항치료후도출현질병진전，필수접수이선방안치료。신적파향약물，제여락안산격매억제제（TKI）랍파체니、포유동물뢰파매소파단백（mTOR）통로억제제의유막사、열휴극단백90（HSP90）억제제AUY922、HER이취화억제제파타주단항이급항체-약물우련물곡타주단항-emtansine（T-DM1），재이곡타주단항위기출적일선치료실패시가이성위이선치료용약。
The prognostic value of human epidermal growth factor receptor 2 (HER2) in gastric cancer is controversial. Consensus guidelines have standardized the testing of HER2 status in gastric cancer. Recently, trastuzumab has emerged as the ifrst targeted drug to improve overall survival when combined with chemotherapy in advanced HER2-positive gastric cancer. Primary and secondary resistance to trastuzumab has become a major problem and new strategies to overcome this resistance are needed. A high percentage of advanced HER2-positive gastric cancer patients who progress on trastuzumab therapy are candidates for second-line therapy. New families of targeted drugs, including tyrosine kinase inhibitors (TKIs) such as lapatinib, mammalian target of rapamycin (mTOR) pathway inhibitors such as everolimus, heat-shock protein 90 (HSP90) inhibitors such as AUY922, HER dimerization inhibitors such as pertuzumab, and antibody-chemotherapy conjugates such as trastuzumab-emtansine (T-DM1), could offer alternative second-line treatments when trastuzumab-based ifrst-line therapy fails.