위장관 종양 약물 치료에서의 최신 동향: 정밀의료의 임상적 적용과 일차 진료와 다학제 팀 접근

Purpose: This review introduces recent advances in systemic treatment for gastrointestinal (GI) malignancies, emphasizing the translation of research innovations into clinical practice. The review aims to establish an effective clinical workflow, from diagnosis to final treatment, through close collaboration and networking between primary physicians and multidisciplinary cancer teams, integrating newly developed technologies and therapeutic strategies. Current Concepts: Precision medicine enables individualized treatment tailored to the genomic and molecular characteristics of each tumor, facilitated by next-generation sequencing (NGS). Recently, NGS-guided targeted therapies and clinical trials involving novel agents have expanded in gastric, hepato-biliary, pancreatic, and colorectal cancers, yielding promising results that may redefine standard treatment paradigms. In stage II colon cancer, postoperative circulating tumor DNA (ctDNA) testing provides valuable prognostic information and helps guide adjuvant chemotherapy decisions, reducing overtreatment. Emerging agents, such as bispecific antibodies and antibody-drug conjugates, combine dual targeting mechanisms, resulting in synergistic efficacy. Although these novel therapeutics are currently being actively investigated in GI cancers, they also introduce new immune-related toxicities that require vigilant monitoring and management. Discussion and Conclusion: For the efficient clinical application of advanced techniques, including genomic profiling, ctDNA-based approaches, and novel therapeutics, an integrated, multidisciplinary strategy is essential. Effective coordination and communication between primary physicians and multidisciplinary teams are critical from diagnosis through treatment planning. Medical oncologists, as key coordinators, play a central role in ensuring that patients benefit from optimized, evidence-based care within a collaborative multidisciplinary framework.