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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medalphabet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский алфавит</journal-title><trans-title-group xml:lang="en"><trans-title>Medical alphabet</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-5631</issn><issn pub-type="epub">2949-2807</issn><publisher><publisher-name>ООО «Альфмед»</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">medalphabet-265</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>Лекарственная терапия второй и последующих линий при раке желудка. Шаг вперед после долгих лет застоя?</article-title><trans-title-group xml:lang="en"><trans-title>Second and further lines of the therapy in metastatic gastric carcinoma. Step forward after stagnation years?</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Трякин</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tryakin</surname><given-names>A. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Федянин</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Fedyanin</surname><given-names>M. U.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр онкологии имени Н.Н. Блохина» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Oncological Scientific Centre n.a. N.N. Blokhin</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>14</day><month>08</month><year>2017</year></pub-date><volume>2</volume><issue>25</issue><issue-title>Диагностика и онкотерапия</issue-title><fpage>6</fpage><lpage>11</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Трякин А.А., Федянин М.Ю., 2017</copyright-statement><copyright-year>2017</copyright-year><copyright-holder xml:lang="ru">Трякин А.А., Федянин М.Ю.</copyright-holder><copyright-holder xml:lang="en">Tryakin A.A., Fedyanin M.U.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-alphabet.com/jour/article/view/265">https://www.med-alphabet.com/jour/article/view/265</self-uri><abstract><p>В данной статье суммированы последние данные, касающиеся лекарственной терапии второй и последующих линий пациентов с метастатическим раком желудка. Рассматриваются различные варианты классической химиотерапии, а также таргетная терапия, в частности, анти-PD моноклональные антитела и рамуцирумаб, достоверно увеличивающие продолжительность жизни пациентов. Применение прогностических моделей, основанных на факторах риска, позволяет отбирать пациентов с наибольшим выигрышем от проведения терапии второй линии.</p></abstract><trans-abstract xml:lang="en"><p>This article summarizes the latest data concerning second and later lines treatments of patients with metastatic gastric carcinoma. Different variants of classical chemotherapy as well as targeted therapy (anti-PD checkpoint inhibitors, ramucirumab) significantly improve overall survival. Risk models based on prognostic factors help to select patients with most benefit on second-line treatment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак желудка</kwd><kwd>вторая линия</kwd><kwd>химиотерапия</kwd><kwd>таргетная терапия</kwd><kwd>факторы риска</kwd><kwd>рамуцирумаб</kwd></kwd-group><kwd-group xml:lang="en"><kwd>stomach cancer</kwd><kwd>second line</kwd><kwd>chemotherapy</kwd><kwd>targeted therapy</kwd><kwd>risk factors</kwd><kwd>ramucirumab</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. Злокачественные новообразования в России в 2014 года (заболеваемость и смертность). М.: МНИОИ им. П.А. Герцена филиал ФГБУ «НМИРЦ» Минздрава России, 2016. 250 с. ISBN 978-5-85502-219-3.</mixed-citation><mixed-citation xml:lang="en">Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. 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