Perioperative chemotherapy for gastric cancer has made steady progress with the application of chemotherapeutic agents and conduct of relevant clinical trials. However, palliative chemotherapy has only made marginal progress, and the median survival remains between 8-10 months. An emerging understanding of tumor biology, cellular and molecular mechanisms has revealed novel targets in gastric cancer therapy, such as trastuzumab, bevacizumab, cetuximab, etc. There are still some problems in clinical practice due to the high heterogeneity of gastric cancer including optimization of perioperative chemotherapy regimen, determination of right strategy to personalize chemotherapy or target therapy for advanced gastric cancer. In order to practically achieve individualized therapy, multicenter, prospective, randomized clinical trials according specific matters of gastric cancer should be performed in China. A deeper understanding of the biological characteristics of gastric cancer, and more translational medicine research and multi-disciplinary team collaboration should be carried out to achieve personalized medicine.