Medical management of gastric cancer: a 2017 update

Cancer Med. 2018 Jan;7(1):123-133. doi: 10.1002/cam4.1274. Epub 2017 Dec 13.

Abstract

Gastric cancer remains a considerable health burden throughout the world. The Cancer Genome Atlas (TCGA) analysis has recently unveiled 4 genotypes of gastric cancer with data not ready to change treatment strategy yet. A multimodality approach to therapy is the cornerstone of screening, diagnosing, staging, treating and supporting patients with gastric cancer. The evidence-based approach to localized gastric cancer (>cT1b) is to use an either preoperative or postoperative strategy to maximize the benefit of surgery. The focus of future research is to optimize chemotherapy regimens, determine the role of radiation therapy and investigate the effect of treatment timing. In metastatic gastric cancer, biologic therapies have been introduced targeting markers shown to be prognostic. The results of ongoing randomized controlled phase 3 trials using targeted and immunotherapy agents, either in combination or alone, have the potential to alter the current treatment landscape of advanced gastric cancer.

Keywords: Gastric cancer; molecular characteristics; multimodality treatment approach; new therapies; pathologic characteristics.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / antagonists & inhibitors
  • Biomarkers, Tumor / genetics
  • Chemotherapy, Adjuvant / methods
  • Clinical Trials, Phase III as Topic
  • Gastrectomy*
  • Global Burden of Disease
  • Humans
  • Molecular Targeted Therapy / methods
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / therapy*

Substances

  • Biomarkers, Tumor