Updates in Version 3.2019 of the NCCN Guidelines for Gastric Cancer from Version 2.2019 include:
美国国立卫生研究院胃癌指南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.”
- 以下关于生物仿制药的新脚注被添加到指南中所有提到的曲妥珠单抗中，“FDA批准的生物类似物是曲妥珠单抗的合适替代品。”
GAST-F Principles of Systemic Therapy
系统治疗的GAST-F原则
3 of 12 Systemic Therapy for Unresectable Locally Advanced, Recurrent or Metastatic Disease
12-3 不能切除的局部晚期、复发或转移性疾病的系统治疗
• 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.
一线治疗
- 建议“HER2过表达的转移性腺癌应在一线化疗中加用曲妥珠单抗”，对子项目进行了修改。
- “与氟嘧啶和顺铂联合(第1类)”和“与其他化疗药物联合(2B类)”作为子项被删除。
- “与氟嘧啶和铂联合(第1类与顺铂联合；第2A类与其他铂剂联合)”作为子项目符号增加。
- 其他推荐方案
◊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
二线或后续治疗；首选方案
Pembrolizumab建议“首选方案”下列出的“用于PD-L1表达水平为≥1的CP的三线或后续治疗胃腺癌”。以前它被列在“其他推荐方案”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 系统治疗的原则.方案和给药时间表
方案和剂量计划页面已更新，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
参考页面已更新，以反映算法中的更改。