{"id":3971,"date":"2025-04-26T00:42:30","date_gmt":"2025-04-25T21:12:30","guid":{"rendered":"https:\/\/gimed.ir\/gastric-cancer\/?page_id=3971"},"modified":"2025-04-27T00:33:03","modified_gmt":"2025-04-26T21:03:03","slug":"advanced-metastatic-unresectable-oesophageal-oesophagogastric-junction-or-gastric-adenocarcinoma-in-her2-negative","status":"publish","type":"page","link":"https:\/\/gimed.ir\/gastric-cancer\/advanced-metastatic-unresectable-oesophageal-oesophagogastric-junction-or-gastric-adenocarcinoma-in-her2-negative\/","title":{"rendered":"Advanced\/metastatic unresectable oesophageal, oesophagogastric junction or gastric adenocarcinoma in HER2-negative"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3971\" class=\"elementor elementor-3971\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d41f189 e-flex e-con-boxed e-con e-parent\" data-id=\"d41f189\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-495cc02 elementor-widget elementor-widget-hotspot\" data-id=\"495cc02\" data-element_type=\"widget\" data-settings=\"{&quot;hotspot&quot;:[{&quot;hotspot_icon&quot;:{&quot;value&quot;:&quot;fas fa-exclamation-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;hotspot_tooltip_content&quot;:&quot;&lt;ul&gt;&lt;li&gt;\\u062f\\u0631\\u0645\\u0627\\u0646 \\u062e\\u0637 \\u0627\\u0648\\u0644 \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc (ChT) \\u0628\\u0627 \\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u06cc\\u06a9 \\u0639\\u0627\\u0645\\u0644 \\u067e\\u0644\\u0627\\u062a\\u06cc\\u0646\\u06cc \\u0648 \\u0641\\u0644\\u0648\\u0626\\u0648\\u0631\\u0648\\u067e\\u06cc\\u0631\\u06cc\\u0645\\u06cc\\u062f\\u06cc\\u0646 \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f. \\u0627\\u06af\\u0632\\u0627\\u0644\\u06cc\\u200c\\u067e\\u0644\\u0627\\u062a\\u06cc\\u0646 \\u0628\\u0647\\u200c\\u0648\\u06cc\\u0698\\u0647 \\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0645\\u0633\\u0646\\u060c \\u06af\\u0632\\u06cc\\u0646\\u0647 \\u0627\\u0631\\u062c\\u062d \\u0627\\u0633\\u062a (Al-Batran, 2008). \\u062f\\u0627\\u0631\\u0648\\u06cc S-1 \\u0645\\u0639\\u0645\\u0648\\u0644\\u0627\\u064b \\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0622\\u0633\\u06cc\\u0627\\u06cc\\u06cc \\u0645\\u0648\\u0631\\u062f \\u0627\\u0633\\u062a\\u0641\\u0627\\u062f\\u0647 \\u0642\\u0631\\u0627\\u0631 \\u0645\\u06cc\\u200c\\u06af\\u06cc\\u0631\\u062f . (Koizumi, 2008)\\u00a0&lt;\\\/li&gt;&lt;li&gt;\\u0628\\u0647 \\u062f\\u0644\\u06cc\\u0644 \\u0633\\u0637\\u0648\\u062d \\u0628\\u0627\\u0644\\u0627\\u062a\\u0631 \\u0633\\u0645\\u06cc\\u062a \\u0648 \\u0639\\u062f\\u0645 \\u0642\\u0637\\u0639\\u06cc\\u062a \\u062f\\u0631 \\u0645\\u0632\\u06cc\\u062a \\u0628\\u0642\\u0627 \\u0646\\u0633\\u0628\\u062a \\u0628\\u0647 \\u0631\\u0698\\u06cc\\u0645\\u200c\\u0647\\u0627\\u06cc \\u062f\\u0648\\u062a\\u0627\\u06cc\\u06cc \\u062a\\u0648\\u0635\\u06cc\\u0647\\u200c\\u0634\\u062f\\u0647\\u060c \\u0627\\u0633\\u062a\\u0641\\u0627\\u062f\\u0647 \\u0627\\u0632 \\u0631\\u0698\\u06cc\\u0645\\u200c\\u0647\\u0627\\u06cc \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc \\u0633\\u0647\\u200c\\u062f\\u0627\\u0631\\u0648\\u06cc\\u06cc \\u0645\\u0628\\u062a\\u0646\\u06cc \\u0628\\u0631 \\u062a\\u0627\\u06a9\\u0633\\u0627\\u0646 \\u0628\\u0647\\u200c\\u0639\\u0646\\u0648\\u0627\\u0646 \\u0631\\u0648\\u06cc\\u06a9\\u0631\\u062f \\u0627\\u0633\\u062a\\u0627\\u0646\\u062f\\u0627\\u0631\\u062f \\u062f\\u0631 \\u062e\\u0637 \\u0627\\u0648\\u0644 \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0646\\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f.&lt;\\\/li&gt;&lt;li&gt;\\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u0627\\u06cc\\u0631\\u06cc\\u0646\\u0648\\u062a\\u06a9\\u0627\\u0646\\u20135-FU \\u0645\\u06cc\\u200c\\u062a\\u0648\\u0627\\u0646\\u062f \\u0628\\u0647\\u200c\\u0639\\u0646\\u0648\\u0627\\u0646 \\u06cc\\u06a9 \\u06af\\u0632\\u06cc\\u0646\\u0647 \\u062c\\u0627\\u06cc\\u06af\\u0632\\u06cc\\u0646 \\u0628\\u0631\\u0627\\u06cc \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646\\u06cc \\u06a9\\u0647 \\u062a\\u062d\\u0645\\u0644 \\u062a\\u0631\\u06a9\\u06cc\\u0628\\u0627\\u062a \\u067e\\u0644\\u0627\\u062a\\u06cc\\u0646\\u06cc \\u0631\\u0627 \\u0646\\u062f\\u0627\\u0631\\u0646\\u062f\\u060c \\u062f\\u0631 \\u0646\\u0638\\u0631 \\u06af\\u0631\\u0641\\u062a\\u0647 \\u0634\\u0648\\u062f (Dank, 2008; Guimbaud, 2014).&lt;\\\/li&gt;&lt;\\\/ul&gt;&quot;,&quot;hotspot_offset_x&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:60,&quot;sizes&quot;:[]},&quot;hotspot_offset_y&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:30,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_position&quot;:&quot;yes&quot;,&quot;hotspot_position&quot;:&quot;top&quot;,&quot;hotspot_tooltip_width&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:486,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_text_wrap&quot;:&quot;yes&quot;,&quot;_id&quot;:&quot;4428677&quot;,&quot;hotspot_label&quot;:&quot;&quot;,&quot;hotspot_link&quot;:{&quot;url&quot;:&quot;&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;},&quot;hotspot_custom_size&quot;:&quot;no&quot;,&quot;hotspot_horizontal&quot;:&quot;right&quot;,&quot;hotspot_vertical&quot;:&quot;top&quot;},{&quot;hotspot_icon&quot;:{&quot;value&quot;:&quot;fas fa-exclamation-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;hotspot_tooltip_content&quot;:&quot;&lt;ul&gt;&lt;li&gt;\\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u0646\\u06cc\\u0648\\u0648\\u0644\\u0648\\u0645\\u0627\\u0628\\u2013\\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc (ChT) \\u0628\\u0631\\u0627\\u06cc \\u0622\\u062f\\u0646\\u0648\\u06a9\\u0627\\u0631\\u0633\\u06cc\\u0646\\u0648\\u0645\\u0627\\u06cc \\u0645\\u0639\\u062f\\u0647\\u060c \\u0645\\u062d\\u0644 \\u0627\\u062a\\u0635\\u0627\\u0644 \\u0645\\u0631\\u06cc-\\u0645\\u0639\\u062f\\u0647 (OGJ) \\u0648 \\u0645\\u0631\\u06cc\\u060c \\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0628\\u0627 PD-L1 CPS \\u22655\\u060c \\u0628\\u0631 \\u0627\\u0633\\u0627\\u0633 \\u0646\\u062a\\u0627\\u06cc\\u062c \\u0645\\u0637\\u0627\\u0644\\u0639\\u0647 CheckMate 649 \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f. (Janjigian, 2021)\\u00a0&lt;\\\/li&gt;&lt;li&gt;\\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u067e\\u0645\\u0628\\u0631\\u0648\\u0644\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628\\u2013\\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc \\u0628\\u0631\\u0627\\u06cc \\u0622\\u062f\\u0646\\u0648\\u06a9\\u0627\\u0631\\u0633\\u06cc\\u0646\\u0648\\u0645\\u0627\\u06cc \\u0645\\u0639\\u062f\\u0647 \\u0648 OGJ\\u060c \\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0628\\u0627 PD-L1 \\u22651\\u060c \\u0628\\u0631 \\u0627\\u0633\\u0627\\u0633 \\u0646\\u062a\\u0627\\u06cc\\u062c \\u0645\\u0637\\u0627\\u0644\\u0639\\u0647 KEYNOTE-859 \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f. (Rha, 2023)\\u00a0&lt;\\\/li&gt;&lt;li&gt;\\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u067e\\u0645\\u0628\\u0631\\u0648\\u0644\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628\\u2013\\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc \\u0628\\u0631\\u0627\\u06cc \\u0622\\u062f\\u0646\\u0648\\u06a9\\u0627\\u0631\\u0633\\u06cc\\u0646\\u0648\\u0645\\u0627\\u06cc \\u0645\\u0631\\u06cc\\u060c \\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0628\\u0627 PD-L1 CPS \\u226510\\u060c \\u0628\\u0631 \\u0627\\u0633\\u0627\\u0633 \\u0646\\u062a\\u0627\\u06cc\\u062c \\u0645\\u0637\\u0627\\u0644\\u0639\\u0647 KEYNOTE-590 \\u0628\\u0627\\u06cc\\u062f \\u0645\\u0648\\u0631\\u062f \\u062a\\u0648\\u062c\\u0647 \\u0642\\u0631\\u0627\\u0631 \\u06af\\u06cc\\u0631\\u062f.&lt;\\\/li&gt;&lt;li&gt;\\u00a0&lt;\\\/li&gt;&lt;\\\/ul&gt;&quot;,&quot;hotspot_offset_x&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:100,&quot;sizes&quot;:[]},&quot;hotspot_offset_y&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:53,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_position&quot;:&quot;yes&quot;,&quot;hotspot_position&quot;:&quot;top&quot;,&quot;hotspot_tooltip_width&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:486,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_text_wrap&quot;:&quot;yes&quot;,&quot;_id&quot;:&quot;6a074ec&quot;,&quot;hotspot_label&quot;:&quot;&quot;,&quot;hotspot_link&quot;:{&quot;url&quot;:&quot;&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;},&quot;hotspot_custom_size&quot;:&quot;no&quot;,&quot;hotspot_horizontal&quot;:&quot;right&quot;,&quot;hotspot_vertical&quot;:&quot;top&quot;},{&quot;hotspot_icon&quot;:{&quot;value&quot;:&quot;fas fa-exclamation-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;hotspot_tooltip_content&quot;:&quot;&lt;ul&gt;&lt;li&gt;\\u0627\\u0641\\u0632\\u0648\\u062f\\u0646 \\u0632\\u0644\\u0628\\u062a\\u0648\\u06a9\\u0633\\u06cc\\u0645\\u0627\\u0628 \\u0628\\u0647 \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc \\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0645\\u0628\\u062a\\u0644\\u0627 \\u0628\\u0647 \\u062a\\u0648\\u0645\\u0648\\u0631\\u0647\\u0627\\u06cc HER2-\\u0645\\u0646\\u0641\\u06cc \\u0648 PD-L1-\\u0645\\u0646\\u0641\\u06cc\\u060c \\u062f\\u0631 \\u0634\\u0631\\u0627\\u06cc\\u0637 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u06cc \\u0645\\u062a\\u0627\\u0633\\u062a\\u0627\\u062a\\u06cc\\u06a9 \\u062e\\u0637 \\u0627\\u0648\\u0644\\u060c \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f&lt;\\\/li&gt;&lt;li&gt;\\u0632\\u0644\\u0628\\u062a\\u0648\\u06a9\\u0633\\u06cc\\u0645\\u0627\\u0628 \\u06cc\\u06a9 \\u06af\\u0632\\u06cc\\u0646\\u0647 \\u0628\\u0627\\u0644\\u0642\\u0648\\u0647 \\u0628\\u0631\\u0627\\u06cc \\u0628\\u0631\\u062e\\u06cc \\u0627\\u0632 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0645\\u0628\\u062a\\u0644\\u0627 \\u0628\\u0647 \\u062a\\u0648\\u0645\\u0648\\u0631\\u0647\\u0627\\u06cc \\u06a9\\u0644\\u0648\\u062f\\u06cc\\u0646-18.2-\\u0645\\u062b\\u0628\\u062a\\u060c HER2-\\u0645\\u0646\\u0641\\u06cc \\u0648 PD-L1-\\u0645\\u062b\\u0628\\u062a \\u0645\\u062d\\u0633\\u0648\\u0628 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f. \\u0628\\u0627 \\u0627\\u06cc\\u0646 \\u062d\\u0627\\u0644\\u060c \\u0627\\u0641\\u0632\\u0648\\u062f\\u0646 \\u06cc\\u06a9\\u06cc \\u0627\\u0632 \\u0645\\u0647\\u0627\\u0631\\u06a9\\u0646\\u0646\\u062f\\u0647\\u200c\\u0647\\u0627\\u06cc \\u0627\\u06cc\\u0645\\u0646\\u06cc\\u200c \\u0646\\u0642\\u0627\\u0637 \\u0628\\u0627\\u0632\\u0631\\u0633\\u06cc immune checkpoint inhibitors) \\u062a\\u0623\\u06cc\\u06cc\\u062f\\u0634\\u062f\\u0647 \\u0628\\u0631\\u0627\\u06cc \\u0627\\u06cc\\u0646 \\u0627\\u0646\\u062f\\u06cc\\u06a9\\u0627\\u0633\\u06cc\\u0648\\u0646\\u060c \\u0628\\u0647\\u200c\\u0639\\u0646\\u0648\\u0627\\u0646 \\u06cc\\u06a9 \\u062c\\u0627\\u06cc\\u06af\\u0632\\u06cc\\u0646 \\u0645\\u0639\\u062a\\u0628\\u0631 \\u062f\\u0631 \\u0646\\u0638\\u0631 \\u06af\\u0631\\u0641\\u062a\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f.&lt;\\\/li&gt;&lt;li&gt;\\u00a0&lt;\\\/li&gt;&lt;\\\/ul&gt;&quot;,&quot;hotspot_offset_x&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:73,&quot;sizes&quot;:[]},&quot;hotspot_offset_y&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:54,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_position&quot;:&quot;yes&quot;,&quot;hotspot_position&quot;:&quot;top&quot;,&quot;hotspot_tooltip_width&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:486,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_text_wrap&quot;:&quot;yes&quot;,&quot;_id&quot;:&quot;2a5a7b3&quot;,&quot;hotspot_label&quot;:&quot;&quot;,&quot;hotspot_link&quot;:{&quot;url&quot;:&quot;&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;},&quot;hotspot_custom_size&quot;:&quot;no&quot;,&quot;hotspot_horizontal&quot;:&quot;right&quot;,&quot;hotspot_vertical&quot;:&quot;top&quot;},{&quot;hotspot_icon&quot;:{&quot;value&quot;:&quot;fas fa-exclamation-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;hotspot_tooltip_content&quot;:&quot;&lt;ul&gt;&lt;li&gt;\\u06af\\u0627\\u0633\\u062a\\u0631\\u06a9\\u062a\\u0648\\u0645\\u06cc \\u062f\\u0631 \\u0633\\u0631\\u0637\\u0627\\u0646 \\u0645\\u0639\\u062f\\u0647 \\u0645\\u062a\\u0627\\u0633\\u062a\\u0627\\u062a\\u06cc\\u06a9\\u060c \\u0645\\u06af\\u0631 \\u062f\\u0631 \\u0645\\u0648\\u0627\\u0631\\u062f\\u06cc \\u06a9\\u0647 \\u0628\\u0627 \\u0647\\u062f\\u0641 \\u062a\\u0633\\u06a9\\u06cc\\u0646 \\u0639\\u0644\\u0627\\u0626\\u0645 \\u0636\\u0631\\u0648\\u0631\\u062a \\u062f\\u0627\\u0634\\u062a\\u0647 \\u0628\\u0627\\u0634\\u062f\\u060c \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0646\\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f.&lt;\\\/li&gt;&lt;li&gt;\\u0628\\u0631\\u062f\\u0627\\u0634\\u062a\\u0646 \\u0645\\u062a\\u0627\\u0633\\u062a\\u0627\\u0632\\u0647\\u0627 \\u0628\\u0647\\u200c\\u0637\\u0648\\u0631 \\u06a9\\u0644\\u06cc \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0646\\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f\\u060c \\u0627\\u0645\\u0627 \\u0645\\u0645\\u06a9\\u0646 \\u0627\\u0633\\u062a \\u0628\\u0647\\u200c\\u0639\\u0646\\u0648\\u0627\\u0646 \\u06cc\\u06a9 \\u0631\\u0648\\u06cc\\u06a9\\u0631\\u062f \\u0641\\u0631\\u062f\\u06cc \\u062f\\u0631 \\u0645\\u0648\\u0627\\u0631\\u062f \\u0628\\u0633\\u06cc\\u0627\\u0631 \\u062e\\u0627\\u0635 \\u0628\\u0627 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u06cc \\u0627\\u0644\\u06cc\\u06af\\u0648\\u0645\\u062a\\u0627\\u0633\\u062a\\u0627\\u062a\\u06cc\\u06a9 \\u0648 \\u067e\\u0627\\u0633\\u062e \\u0645\\u0646\\u0627\\u0633\\u0628 \\u0628\\u0647 \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc \\u0645\\u0648\\u0631\\u062f \\u062a\\u0648\\u062c\\u0647 \\u0642\\u0631\\u0627\\u0631 \\u06af\\u06cc\\u0631\\u062f.&lt;\\\/li&gt;&lt;li&gt;\\u00a0&lt;\\\/li&gt;&lt;\\\/ul&gt;&quot;,&quot;hotspot_offset_x&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:62,&quot;sizes&quot;:[]},&quot;hotspot_offset_y&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:95,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_position&quot;:&quot;yes&quot;,&quot;hotspot_position&quot;:&quot;bottom&quot;,&quot;hotspot_tooltip_width&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:486,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_text_wrap&quot;:&quot;yes&quot;,&quot;_id&quot;:&quot;0504a7d&quot;,&quot;hotspot_label&quot;:&quot;&quot;,&quot;hotspot_link&quot;:{&quot;url&quot;:&quot;&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;},&quot;hotspot_custom_size&quot;:&quot;no&quot;,&quot;hotspot_horizontal&quot;:&quot;right&quot;,&quot;hotspot_vertical&quot;:&quot;top&quot;}],&quot;tooltip_trigger&quot;:&quot;mouseenter&quot;,&quot;hotspot_sequenced_animation&quot;:&quot;no&quot;,&quot;tooltip_position&quot;:&quot;top&quot;,&quot;tooltip_animation&quot;:&quot;e-hotspot--fade-in-out&quot;}\" data-widget_type=\"hotspot.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"712\" height=\"535\" src=\"https:\/\/gimed.ir\/gastric-cancer\/wp-content\/uploads\/2025\/04\/Picture1.png\" class=\"attachment-large size-large wp-image-3973\" alt=\"\" srcset=\"https:\/\/gimed.ir\/gastric-cancer\/wp-content\/uploads\/2025\/04\/Picture1.png 712w, https:\/\/gimed.ir\/gastric-cancer\/wp-content\/uploads\/2025\/04\/Picture1-500x376.png 500w, https:\/\/gimed.ir\/gastric-cancer\/wp-content\/uploads\/2025\/04\/Picture1-300x225.png 300w\" sizes=\"(max-width: 712px) 100vw, 712px\" \/>\n\t\t\t\t\t\t<div class=\"e-hotspot elementor-repeater-item-4428677  e-hotspot--position-right e-hotspot--position-top   e-hotspot--icon\">\n\n\t\t\t\t\t\t\t\t<div class=\"e-hotspot__button e-hotspot--expand\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__icon\"><svg class=\"e-font-icon-svg e-fas-exclamation-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__tooltip  e-hotspot--tooltip-position e-hotspot--fade-in-out \" >\n\t\t\t\t\t\t<ul><li>\u062f\u0631\u0645\u0627\u0646 \u062e\u0637 \u0627\u0648\u0644 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc (ChT) \u0628\u0627 \u062a\u0631\u06a9\u06cc\u0628 \u06cc\u06a9 \u0639\u0627\u0645\u0644 \u067e\u0644\u0627\u062a\u06cc\u0646\u06cc \u0648 \u0641\u0644\u0648\u0626\u0648\u0631\u0648\u067e\u06cc\u0631\u06cc\u0645\u06cc\u062f\u06cc\u0646 \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f. \u0627\u06af\u0632\u0627\u0644\u06cc\u200c\u067e\u0644\u0627\u062a\u06cc\u0646 \u0628\u0647\u200c\u0648\u06cc\u0698\u0647 \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0645\u0633\u0646\u060c \u06af\u0632\u06cc\u0646\u0647 \u0627\u0631\u062c\u062d \u0627\u0633\u062a (Al-Batran, 2008). \u062f\u0627\u0631\u0648\u06cc S-1 \u0645\u0639\u0645\u0648\u0644\u0627\u064b \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0622\u0633\u06cc\u0627\u06cc\u06cc \u0645\u0648\u0631\u062f \u0627\u0633\u062a\u0641\u0627\u062f\u0647 \u0642\u0631\u0627\u0631 \u0645\u06cc\u200c\u06af\u06cc\u0631\u062f . (Koizumi, 2008)\u00a0<\/li><li>\u0628\u0647 \u062f\u0644\u06cc\u0644 \u0633\u0637\u0648\u062d \u0628\u0627\u0644\u0627\u062a\u0631 \u0633\u0645\u06cc\u062a \u0648 \u0639\u062f\u0645 \u0642\u0637\u0639\u06cc\u062a \u062f\u0631 \u0645\u0632\u06cc\u062a \u0628\u0642\u0627 \u0646\u0633\u0628\u062a \u0628\u0647 \u0631\u0698\u06cc\u0645\u200c\u0647\u0627\u06cc \u062f\u0648\u062a\u0627\u06cc\u06cc \u062a\u0648\u0635\u06cc\u0647\u200c\u0634\u062f\u0647\u060c \u0627\u0633\u062a\u0641\u0627\u062f\u0647 \u0627\u0632 \u0631\u0698\u06cc\u0645\u200c\u0647\u0627\u06cc \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u0633\u0647\u200c\u062f\u0627\u0631\u0648\u06cc\u06cc \u0645\u0628\u062a\u0646\u06cc \u0628\u0631 \u062a\u0627\u06a9\u0633\u0627\u0646 \u0628\u0647\u200c\u0639\u0646\u0648\u0627\u0646 \u0631\u0648\u06cc\u06a9\u0631\u062f \u0627\u0633\u062a\u0627\u0646\u062f\u0627\u0631\u062f \u062f\u0631 \u062e\u0637 \u0627\u0648\u0644 \u062a\u0648\u0635\u06cc\u0647 \u0646\u0645\u06cc\u200c\u0634\u0648\u062f.<\/li><li>\u062a\u0631\u06a9\u06cc\u0628 \u0627\u06cc\u0631\u06cc\u0646\u0648\u062a\u06a9\u0627\u0646\u20135-FU \u0645\u06cc\u200c\u062a\u0648\u0627\u0646\u062f \u0628\u0647\u200c\u0639\u0646\u0648\u0627\u0646 \u06cc\u06a9 \u06af\u0632\u06cc\u0646\u0647 \u062c\u0627\u06cc\u06af\u0632\u06cc\u0646 \u0628\u0631\u0627\u06cc \u0628\u06cc\u0645\u0627\u0631\u0627\u0646\u06cc \u06a9\u0647 \u062a\u062d\u0645\u0644 \u062a\u0631\u06a9\u06cc\u0628\u0627\u062a \u067e\u0644\u0627\u062a\u06cc\u0646\u06cc \u0631\u0627 \u0646\u062f\u0627\u0631\u0646\u062f\u060c \u062f\u0631 \u0646\u0638\u0631 \u06af\u0631\u0641\u062a\u0647 \u0634\u0648\u062f (Dank, 2008; Guimbaud, 2014).<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t<\/div>\n\n\t\n\t\t\t\t\t\t<div class=\"e-hotspot elementor-repeater-item-6a074ec  e-hotspot--position-right e-hotspot--position-top   e-hotspot--icon\">\n\n\t\t\t\t\t\t\t\t<div class=\"e-hotspot__button e-hotspot--expand\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__icon\"><svg class=\"e-font-icon-svg e-fas-exclamation-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__tooltip  e-hotspot--tooltip-position e-hotspot--fade-in-out \" >\n\t\t\t\t\t\t<ul><li>\u062a\u0631\u06a9\u06cc\u0628 \u0646\u06cc\u0648\u0648\u0644\u0648\u0645\u0627\u0628\u2013\u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc (ChT) \u0628\u0631\u0627\u06cc \u0622\u062f\u0646\u0648\u06a9\u0627\u0631\u0633\u06cc\u0646\u0648\u0645\u0627\u06cc \u0645\u0639\u062f\u0647\u060c \u0645\u062d\u0644 \u0627\u062a\u0635\u0627\u0644 \u0645\u0631\u06cc-\u0645\u0639\u062f\u0647 (OGJ) \u0648 \u0645\u0631\u06cc\u060c \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0628\u0627 PD-L1 CPS \u22655\u060c \u0628\u0631 \u0627\u0633\u0627\u0633 \u0646\u062a\u0627\u06cc\u062c \u0645\u0637\u0627\u0644\u0639\u0647 CheckMate 649 \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f. (Janjigian, 2021)\u00a0<\/li><li>\u062a\u0631\u06a9\u06cc\u0628 \u067e\u0645\u0628\u0631\u0648\u0644\u06cc\u0632\u0648\u0645\u0627\u0628\u2013\u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u0628\u0631\u0627\u06cc \u0622\u062f\u0646\u0648\u06a9\u0627\u0631\u0633\u06cc\u0646\u0648\u0645\u0627\u06cc \u0645\u0639\u062f\u0647 \u0648 OGJ\u060c \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0628\u0627 PD-L1 \u22651\u060c \u0628\u0631 \u0627\u0633\u0627\u0633 \u0646\u062a\u0627\u06cc\u062c \u0645\u0637\u0627\u0644\u0639\u0647 KEYNOTE-859 \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f. (Rha, 2023)\u00a0<\/li><li>\u062a\u0631\u06a9\u06cc\u0628 \u067e\u0645\u0628\u0631\u0648\u0644\u06cc\u0632\u0648\u0645\u0627\u0628\u2013\u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u0628\u0631\u0627\u06cc \u0622\u062f\u0646\u0648\u06a9\u0627\u0631\u0633\u06cc\u0646\u0648\u0645\u0627\u06cc \u0645\u0631\u06cc\u060c \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0628\u0627 PD-L1 CPS \u226510\u060c \u0628\u0631 \u0627\u0633\u0627\u0633 \u0646\u062a\u0627\u06cc\u062c \u0645\u0637\u0627\u0644\u0639\u0647 KEYNOTE-590 \u0628\u0627\u06cc\u062f \u0645\u0648\u0631\u062f \u062a\u0648\u062c\u0647 \u0642\u0631\u0627\u0631 \u06af\u06cc\u0631\u062f.<\/li><li>\u00a0<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t<\/div>\n\n\t\n\t\t\t\t\t\t<div class=\"e-hotspot elementor-repeater-item-2a5a7b3  e-hotspot--position-right e-hotspot--position-top   e-hotspot--icon\">\n\n\t\t\t\t\t\t\t\t<div class=\"e-hotspot__button e-hotspot--expand\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__icon\"><svg class=\"e-font-icon-svg e-fas-exclamation-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__tooltip  e-hotspot--tooltip-position e-hotspot--fade-in-out \" >\n\t\t\t\t\t\t<ul><li>\u0627\u0641\u0632\u0648\u062f\u0646 \u0632\u0644\u0628\u062a\u0648\u06a9\u0633\u06cc\u0645\u0627\u0628 \u0628\u0647 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0645\u0628\u062a\u0644\u0627 \u0628\u0647 \u062a\u0648\u0645\u0648\u0631\u0647\u0627\u06cc HER2-\u0645\u0646\u0641\u06cc \u0648 PD-L1-\u0645\u0646\u0641\u06cc\u060c \u062f\u0631 \u0634\u0631\u0627\u06cc\u0637 \u0628\u06cc\u0645\u0627\u0631\u06cc \u0645\u062a\u0627\u0633\u062a\u0627\u062a\u06cc\u06a9 \u062e\u0637 \u0627\u0648\u0644\u060c \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f<\/li><li>\u0632\u0644\u0628\u062a\u0648\u06a9\u0633\u06cc\u0645\u0627\u0628 \u06cc\u06a9 \u06af\u0632\u06cc\u0646\u0647 \u0628\u0627\u0644\u0642\u0648\u0647 \u0628\u0631\u0627\u06cc \u0628\u0631\u062e\u06cc \u0627\u0632 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0645\u0628\u062a\u0644\u0627 \u0628\u0647 \u062a\u0648\u0645\u0648\u0631\u0647\u0627\u06cc \u06a9\u0644\u0648\u062f\u06cc\u0646-18.2-\u0645\u062b\u0628\u062a\u060c HER2-\u0645\u0646\u0641\u06cc \u0648 PD-L1-\u0645\u062b\u0628\u062a \u0645\u062d\u0633\u0648\u0628 \u0645\u06cc\u200c\u0634\u0648\u062f. \u0628\u0627 \u0627\u06cc\u0646 \u062d\u0627\u0644\u060c \u0627\u0641\u0632\u0648\u062f\u0646 \u06cc\u06a9\u06cc \u0627\u0632 \u0645\u0647\u0627\u0631\u06a9\u0646\u0646\u062f\u0647\u200c\u0647\u0627\u06cc \u0627\u06cc\u0645\u0646\u06cc\u200c \u0646\u0642\u0627\u0637 \u0628\u0627\u0632\u0631\u0633\u06cc immune checkpoint inhibitors) \u062a\u0623\u06cc\u06cc\u062f\u0634\u062f\u0647 \u0628\u0631\u0627\u06cc \u0627\u06cc\u0646 \u0627\u0646\u062f\u06cc\u06a9\u0627\u0633\u06cc\u0648\u0646\u060c \u0628\u0647\u200c\u0639\u0646\u0648\u0627\u0646 \u06cc\u06a9 \u062c\u0627\u06cc\u06af\u0632\u06cc\u0646 \u0645\u0639\u062a\u0628\u0631 \u062f\u0631 \u0646\u0638\u0631 \u06af\u0631\u0641\u062a\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f.<\/li><li>\u00a0<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t<\/div>\n\n\t\n\t\t\t\t\t\t<div class=\"e-hotspot elementor-repeater-item-0504a7d  e-hotspot--position-right e-hotspot--position-top   e-hotspot--icon\">\n\n\t\t\t\t\t\t\t\t<div class=\"e-hotspot__button e-hotspot--expand\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__icon\"><svg class=\"e-font-icon-svg e-fas-exclamation-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zm-248 50c-25.405 0-46 20.595-46 46s20.595 46 46 46 46-20.595 46-46-20.595-46-46-46zm-43.673-165.346l7.418 136c.347 6.364 5.609 11.346 11.982 11.346h48.546c6.373 0 11.635-4.982 11.982-11.346l7.418-136c.375-6.874-5.098-12.654-11.982-12.654h-63.383c-6.884 0-12.356 5.78-11.981 12.654z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__tooltip  e-hotspot--tooltip-position e-hotspot--fade-in-out \" >\n\t\t\t\t\t\t<ul><li>\u06af\u0627\u0633\u062a\u0631\u06a9\u062a\u0648\u0645\u06cc \u062f\u0631 \u0633\u0631\u0637\u0627\u0646 \u0645\u0639\u062f\u0647 \u0645\u062a\u0627\u0633\u062a\u0627\u062a\u06cc\u06a9\u060c \u0645\u06af\u0631 \u062f\u0631 \u0645\u0648\u0627\u0631\u062f\u06cc \u06a9\u0647 \u0628\u0627 \u0647\u062f\u0641 \u062a\u0633\u06a9\u06cc\u0646 \u0639\u0644\u0627\u0626\u0645 \u0636\u0631\u0648\u0631\u062a \u062f\u0627\u0634\u062a\u0647 \u0628\u0627\u0634\u062f\u060c \u062a\u0648\u0635\u06cc\u0647 \u0646\u0645\u06cc\u200c\u0634\u0648\u062f.<\/li><li>\u0628\u0631\u062f\u0627\u0634\u062a\u0646 \u0645\u062a\u0627\u0633\u062a\u0627\u0632\u0647\u0627 \u0628\u0647\u200c\u0637\u0648\u0631 \u06a9\u0644\u06cc \u062a\u0648\u0635\u06cc\u0647 \u0646\u0645\u06cc\u200c\u0634\u0648\u062f\u060c \u0627\u0645\u0627 \u0645\u0645\u06a9\u0646 \u0627\u0633\u062a \u0628\u0647\u200c\u0639\u0646\u0648\u0627\u0646 \u06cc\u06a9 \u0631\u0648\u06cc\u06a9\u0631\u062f \u0641\u0631\u062f\u06cc \u062f\u0631 \u0645\u0648\u0627\u0631\u062f \u0628\u0633\u06cc\u0627\u0631 \u062e\u0627\u0635 \u0628\u0627 \u0628\u06cc\u0645\u0627\u0631\u06cc \u0627\u0644\u06cc\u06af\u0648\u0645\u062a\u0627\u0633\u062a\u0627\u062a\u06cc\u06a9 \u0648 \u067e\u0627\u0633\u062e \u0645\u0646\u0627\u0633\u0628 \u0628\u0647 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u0645\u0648\u0631\u062f \u062a\u0648\u062c\u0647 \u0642\u0631\u0627\u0631 \u06af\u06cc\u0631\u062f.<\/li><li>\u00a0<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t<\/div>\n\n\t\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e6e4784 e-flex e-con-boxed e-con e-parent\" data-id=\"e6e4784\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-605a650 elementor-widget elementor-widget-spacer\" data-id=\"605a650\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-26d5a1c e-flex e-con-boxed e-con e-parent\" data-id=\"26d5a1c\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-db7e2e1 elementor-widget elementor-widget-text-editor\" data-id=\"db7e2e1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>\u00a0<\/p><p>A) \u062a\u0631\u06a9\u06cc\u0628\u0627\u062a \u067e\u0644\u0627\u062a\u06cc\u0646\u06cc \u062a\u0648\u0635\u06cc\u0647\u200c\u0634\u062f\u0647 \u0634\u0627\u0645\u0644 \u0627\u06af\u0632\u0627\u0644\u06cc\u200c\u067e\u0644\u0627\u062a\u06cc\u0646 \u06cc\u0627 \u0633\u06cc\u0633\u200c\u067e\u0644\u0627\u062a\u06cc\u0646 \u0647\u0633\u062a\u0646\u062f. \u0627\u06af\u0632\u0627\u0644\u06cc\u200c\u067e\u0644\u0627\u062a\u06cc\u0646\u060c \u0628\u0647\u200c\u0648\u06cc\u0698\u0647 \u0628\u0631\u0627\u06cc \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0645\u0633\u0646\u060c \u0627\u0631\u062c\u062d \u0627\u0633\u062a. \u0641\u0644\u0648\u0626\u0648\u0631\u0648\u067e\u06cc\u0631\u06cc\u0645\u06cc\u062f\u06cc\u0646\u200c\u0647\u0627\u06cc \u062a\u0648\u0635\u06cc\u0647\u200c\u0634\u062f\u0647 \u0634\u0627\u0645\u0644 5-FU \u062f\u0627\u062e\u0644\u200c\u0648\u0631\u06cc\u062f\u06cc\u060c \u06a9\u0627\u067e\u0633\u06cc\u062a\u0627\u0628\u06cc\u0646 \u062e\u0648\u0631\u0627\u06a9\u06cc \u06cc\u0627 S-1 \u062e\u0648\u0631\u0627\u06a9\u06cc \u0647\u0633\u062a\u0646\u062f. \u062a\u0631\u06a9\u06cc\u0628 \u0627\u06cc\u0631\u06cc\u0646\u0648\u062a\u06a9\u0627\u0646\u20135-FU \u0645\u06cc\u200c\u062a\u0648\u0627\u0646\u062f \u0628\u0647\u200c\u0639\u0646\u0648\u0627\u0646 \u06cc\u06a9 \u06af\u0632\u06cc\u0646\u0647 \u062c\u0627\u06cc\u06af\u0632\u06cc\u0646 \u0628\u0631\u0627\u06cc \u0628\u06cc\u0645\u0627\u0631\u0627\u0646\u06cc \u06a9\u0647 \u062a\u062d\u0645\u0644 \u062a\u0631\u06a9\u06cc\u0628\u0627\u062a \u067e\u0644\u0627\u062a\u06cc\u0646\u06cc \u0631\u0627 \u0646\u062f\u0627\u0631\u0646\u062f \u06cc\u0627 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646\u06cc \u06a9\u0647 \u0645\u062f\u062a \u06a9\u0648\u062a\u0627\u0647\u06cc \u067e\u0633 \u0627\u0632 \u062f\u0631\u06cc\u0627\u0641\u062a \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u0627\u062f\u062c\u0648\u0627\u0646\u062a \u0645\u0628\u062a\u0646\u06cc \u0628\u0631 \u067e\u0644\u0627\u062a\u06cc\u0646 \u062f\u0686\u0627\u0631 \u067e\u06cc\u0634\u0631\u0641\u062a \u0628\u06cc\u0645\u0627\u0631\u06cc \u0634\u062f\u0647\u200c\u0627\u0646\u062f\u060c \u062f\u0631 \u0646\u0638\u0631 \u06af\u0631\u0641\u062a\u0647 \u0634\u0648\u062f.<\/p><p>B) \u0627\u0645\u062a\u06cc\u0627\u0632\u0647\u0627\u06cc ESCAT \u0635\u0631\u0641\u0627\u064b \u0628\u0647 \u062a\u063a\u06cc\u06cc\u0631\u0627\u062a \u0698\u0646\u0648\u0645\u06cc \u0627\u062e\u062a\u0635\u0627\u0635 \u062f\u0627\u0631\u0646\u062f. \u0627\u06cc\u0646 \u0627\u0645\u062a\u06cc\u0627\u0632\u0647\u0627 \u062a\u0648\u0633\u0637 \u0646\u0648\u06cc\u0633\u0646\u062f\u06af\u0627\u0646 \u0631\u0627\u0647\u0646\u0645\u0627 \u062a\u0639\u0631\u06cc\u0641 \u0648 \u062a\u0648\u0633\u0637 \u06af\u0631\u0648\u0647 \u067e\u0698\u0648\u0647\u0634\u200c\u0647\u0627\u06cc \u062a\u0631\u062c\u0645\u0627\u0646\u06cc \u0648 \u067e\u0632\u0634\u06a9\u06cc \u062f\u0642\u06cc\u0642 ESMO \u0645\u0648\u0631\u062f \u0627\u0639\u062a\u0628\u0627\u0631\u0633\u0646\u062c\u06cc \u0642\u0631\u0627\u0631 \u06af\u0631\u0641\u062a\u0647\u200c\u0627\u0646\u062f Mateo, 2018) ).<\/p><p>C) \u062a\u0631\u06a9\u06cc\u0628 \u0646\u06cc\u0648\u0648\u0644\u0648\u0645\u0627\u0628\u2013\u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u0628\u0627\u06cc\u062f \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0645\u0628\u062a\u0644\u0627 \u0628\u0647 \u0622\u062f\u0646\u0648\u06a9\u0627\u0631\u0633\u06cc\u0646\u0648\u0645\u0627\u06cc \u067e\u06cc\u0634\u0631\u0641\u062a\u0647 \u0648 \u062f\u0631\u0645\u0627\u0646\u200c\u0646\u0634\u062f\u0647 \u0645\u0639\u062f\u0647\u060c \u0645\u062d\u0644 \u0627\u062a\u0635\u0627\u0644 \u0645\u0631\u06cc-\u0645\u0639\u062f\u0647 (OGJ) \u0648 \u0645\u0631\u06cc\u060c \u0628\u0627 \u0627\u0645\u062a\u06cc\u0627\u0632 PD-L1 CPS \u0628\u06cc\u0646 1 \u062a\u0627 4 \u0645\u062f\u0646\u0638\u0631 \u0642\u0631\u0627\u0631 \u06af\u06cc\u0631\u062f \u0648 \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0628\u0627 CPS \u22655 \u062a\u062c\u0648\u06cc\u0632 \u0634\u0648\u062f (\u062a\u0623\u06cc\u06cc\u062f FDA \u0628\u062f\u0648\u0646 \u0645\u062d\u062f\u0648\u062f\u06cc\u062a CPS\u060c \u062a\u0623\u06cc\u06cc\u062f EMA \u0628\u0631\u0627\u06cc CPS \u22655 ). \u0633\u0637\u0648\u062d \u0628\u0627\u0644\u0627\u062a\u0631 \u0628\u06cc\u0627\u0646 PD-L1 \u0628\u0627 \u0627\u062b\u0631\u0628\u062e\u0634\u06cc \u0628\u0627\u0644\u0627\u062a\u0631 \u0647\u0645\u0631\u0627\u0647 \u0627\u0633\u062a. CPS \u0628\u06cc\u0646 1 \u062a\u0627 4 \u0628\u0627 \u0627\u062b\u0631\u0628\u062e\u0634\u06cc \u0645\u0631\u0632\u06cc \u0647\u0645\u0631\u0627\u0647 \u0627\u0633\u062a (\u0645\u0627\u0646\u0646\u062f HR 0.95 \u062f\u0631 \u0645\u0637\u0627\u0644\u0639\u0647 CheckMate 649\u060c Janjigian, 2021).<\/p><p>D) \u062a\u0631\u06a9\u06cc\u0628 \u067e\u0645\u0628\u0631\u0648\u0644\u06cc\u0632\u0648\u0645\u0627\u0628\u2013\u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u0628\u0627\u06cc\u062f \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0645\u0628\u062a\u0644\u0627 \u0628\u0647 \u0622\u062f\u0646\u0648\u06a9\u0627\u0631\u0633\u06cc\u0646\u0648\u0645\u0627\u06cc \u067e\u06cc\u0634\u0631\u0641\u062a\u0647 \u0648 \u062f\u0631\u0645\u0627\u0646\u200c\u0646\u0634\u062f\u0647 \u0645\u0639\u062f\u0647\u060c \u0645\u062d\u0644 \u0627\u062a\u0635\u0627\u0644 \u0645\u0631\u06cc-\u0645\u0639\u062f\u0647 \u0648 \u0645\u0631\u06cc\u060c \u0628\u0627 \u0627\u0645\u062a\u06cc\u0627\u0632 PD-L1 CPS \u0628\u06cc\u0646 1 \u062a\u0627 9 \u0645\u062f\u0646\u0638\u0631 \u0642\u0631\u0627\u0631 \u06af\u06cc\u0631\u062f \u0648 \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0628\u0627 CPS \u226510 \u062a\u062c\u0648\u06cc\u0632 \u0634\u0648\u062f (\u062a\u0623\u06cc\u06cc\u062f FDA \u0628\u062f\u0648\u0646 \u0645\u062d\u062f\u0648\u062f\u06cc\u062a CPS\u060c \u062a\u0623\u06cc\u06cc\u062f EMA \u0628\u0631\u0627\u06cc \u0633\u0631\u0637\u0627\u0646 \u0645\u0639\u062f\u0647 \u0648 OGJ \u0628\u0627 CPS \u22651 \u0648 \u0628\u0631\u0627\u06cc \u0622\u062f\u0646\u0648\u06a9\u0627\u0631\u0633\u06cc\u0646\u0648\u0645\u0627\u06cc \u0645\u0631\u06cc \u0628\u0627 CPS \u226510). \u0633\u0637\u0648\u062d \u0628\u0627\u0644\u0627\u062a\u0631 \u0628\u06cc\u0627\u0646 PD-L1 \u0628\u0627 \u0627\u062b\u0631\u0628\u062e\u0634\u06cc \u0628\u0627\u0644\u0627\u062a\u0631 \u0647\u0645\u0631\u0627\u0647 \u0627\u0633\u062a. CPS \u0628\u06cc\u0646 1 \u062a\u0627 9 \u0628\u0627 \u0627\u062b\u0631\u0628\u062e\u0634\u06cc \u0645\u0631\u0632\u06cc \u0647\u0645\u0631\u0627\u0647 \u0627\u0633\u062a (HR 0.83 \u062f\u0631 \u0645\u0637\u0627\u0644\u0639\u0647 KEYNOTE-859\u060c Rha, 2023).<\/p><p>\u0628\u0631 \u0627\u0633\u0627\u0633 \u0646\u062a\u0627\u06cc\u062c \u0645\u062b\u0628\u062a \u0645\u0637\u0627\u0644\u0639\u0627\u062a \u0641\u0627\u0632 3\u060c \u0628\u0631\u062e\u06cc \u062f\u06cc\u06af\u0631 \u0627\u0632 \u0645\u0647\u0627\u0631\u06a9\u0646\u0646\u062f\u0647\u200c\u0647\u0627\u06cc PD-1 \u0646\u06cc\u0632 \u062f\u0631 \u0645\u0646\u0627\u0637\u0642 \u0645\u062e\u062a\u0644\u0641 \u06cc\u0627 \u062a\u0623\u06cc\u06cc\u062f \u0634\u062f\u0647\u200c\u0627\u0646\u062f \u0648\/\u06cc\u0627 \u062f\u0631 \u062f\u0633\u062a\u0631\u0633 \u0647\u0633\u062a\u0646\u062f\u060c \u0645\u0627\u0646\u0646\u062f \u062a\u06cc\u0632\u0644\u06cc\u0632\u0648\u0645\u0627\u0628\u060c \u0633\u06cc\u0646\u062a\u06cc\u0644\u06cc\u0645\u0627\u0628 \u0648 \u062a\u0648\u0631\u06cc\u067e\u0627\u0644\u06cc\u200c\u0645\u0627\u0628.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>\u062f\u0631\u0645\u0627\u0646 \u062e\u0637 \u0627\u0648\u0644 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc (ChT) \u0628\u0627 \u062a\u0631\u06a9\u06cc\u0628 \u06cc\u06a9 \u0639\u0627\u0645\u0644 \u067e\u0644\u0627\u062a\u06cc\u0646\u06cc \u0648 \u0641\u0644\u0648\u0626\u0648\u0631\u0648\u067e\u06cc\u0631\u06cc\u0645\u06cc\u062f\u06cc\u0646 \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f. \u0627\u06af\u0632\u0627\u0644\u06cc\u200c\u067e\u0644\u0627\u062a\u06cc\u0646 \u0628\u0647\u200c\u0648\u06cc\u0698\u0647 \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0645\u0633\u0646\u060c \u06af\u0632\u06cc\u0646\u0647 \u0627\u0631\u062c\u062d \u0627\u0633\u062a (Al-Batran, 2008). \u062f\u0627\u0631\u0648\u06cc S-1 \u0645\u0639\u0645\u0648\u0644\u0627\u064b \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0622\u0633\u06cc\u0627\u06cc\u06cc \u0645\u0648\u0631\u062f \u0627\u0633\u062a\u0641\u0627\u062f\u0647 \u0642\u0631\u0627\u0631 \u0645\u06cc\u200c\u06af\u06cc\u0631\u062f . (Koizumi, 2008)\u00a0 \u0628\u0647 \u062f\u0644\u06cc\u0644 \u0633\u0637\u0648\u062d \u0628\u0627\u0644\u0627\u062a\u0631 \u0633\u0645\u06cc\u062a \u0648 \u0639\u062f\u0645 \u0642\u0637\u0639\u06cc\u062a \u062f\u0631 \u0645\u0632\u06cc\u062a \u0628\u0642\u0627 \u0646\u0633\u0628\u062a \u0628\u0647 \u0631\u0698\u06cc\u0645\u200c\u0647\u0627\u06cc \u062f\u0648\u062a\u0627\u06cc\u06cc \u062a\u0648\u0635\u06cc\u0647\u200c\u0634\u062f\u0647\u060c \u0627\u0633\u062a\u0641\u0627\u062f\u0647 \u0627\u0632 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-3971","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/gimed.ir\/gastric-cancer\/wp-json\/wp\/v2\/pages\/3971","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gimed.ir\/gastric-cancer\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/gimed.ir\/gastric-cancer\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/gimed.ir\/gastric-cancer\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/gimed.ir\/gastric-cancer\/wp-json\/wp\/v2\/comments?post=3971"}],"version-history":[{"count":10,"href":"https:\/\/gimed.ir\/gastric-cancer\/wp-json\/wp\/v2\/pages\/3971\/revisions"}],"predecessor-version":[{"id":3994,"href":"https:\/\/gimed.ir\/gastric-cancer\/wp-json\/wp\/v2\/pages\/3971\/revisions\/3994"}],"wp:attachment":[{"href":"https:\/\/gimed.ir\/gastric-cancer\/wp-json\/wp\/v2\/media?parent=3971"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}