Updates in Version 3.2019 of the NCCN Guidelines for Gastric Cancer from Version 2.2019 include:
美國國立衛生研究院胃癌指南2019.v3版的2019.v2版更新包括：
Global
- The following new footnote regarding biosimilars was added to all mentions of trastuzumab within the guidelines, “An FDA-approved biosimilar is an appropriate substitute for trastuzumab.”
- 以下關於生物仿製藥的新腳註被添加到指南中所有提到的曲妥珠單抗中，“FDA批准的生物類似物是曲妥珠單抗的合適替代品。”
GAST-F Principles of Systemic Therapy
3 of 12 Systemic Therapy for Unresectable Locally Advanced, Recurrent or Metastatic Disease
12-3 不能切除的局部晚期、復發或轉移性疾病的系統治療
• First-Line Therapy
Changes were made to the sub-bullets for the recommendation "Trastuzumab should be added to first-line chemotherapy for HER2 overexpressing metastatic adenocarcinoma"
◊ “Combination with fluoropyrimidine and cisplatin (category 1)” and “Combination with other chemotherapy agents (category 2B)” were removed as sub-bullets.
◊ “Combination with fluoropyrimidine and platinum (category 1 in combination with cisplatin; category 2A in combination with other platinum agents)” was added as sub-bullet.
Other Recommended Regimens
◊ The regimen “Fluorouracil and irinotecan” was moved to the top of the list.
- 建議“HER2過表達的轉移性腺癌應在一線化療中加用曲妥珠單抗”，對子項目進行了修改。
- “與氟嘧啶和順鉑聯合(第1類)”和“與其他化療藥物聯合(2B類)”作為子項被刪除。
- “與氟嘧啶和鉑聯合(第1類與順鉑聯合；第2A類與其他鉑劑聯合)”作為子項目符號增加。
- 其他推薦方案
◊方案“氟尿嘧啶和伊立替康”被移至榜首。
4 of 12 • Second-Line or Subsequent Therapy; Preferred Regimens
Pembrolizumab recommendation "For third-line or subsequent therapy for gastric adenocarcinoma with PD-L1 expression levels by CPS of ≥1" listed under "Preferred regimens". Previously it was listed under "Other recommended regimens".
12-4
Pembrolizumab建議“首選方案”下列出的“用於PD-L1表達水平為≥1的CP的三線或後續治療胃腺癌”。以前它被列在“其他推薦方案”下。
5 of 12 Principles of Systemic Therapy—Regimens and Dosing Schedules • The regimen and dosing schedule pages were updated to reflect the changes on GAST-F 3 of 12 and 4 of 12.
12-5 系統治療的原則.方案和給藥時間表
方案和劑量計劃頁面已更新，以反映GAST-F上的更改12-3和12-4
11 of 12 • The reference pages were updated to reflect the changes in the algorithm.
12-11
參考頁面已更新，以反映算法中的更改。
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