Korean J Helicobacter Up Gastrointest Res.  2013 Sep;13(3):142-146. 10.7704/kjhugr.2013.13.3.142.

Chemotherapy of Advanced Gastric Cancer

• Jung JT

• KMID: 2249478
• DOI: http://doi.org/10.7704/kjhugr.2013.13.3.142

Abstract

Gastric cancer is a common malignancy worldwide with a high mortality rate. In advanced gastric cancer, combination chemotherapy improves overall survival compared with best supportive care alone. However, there is no standard regimen for first-line chemotherapy. 5-fluorouracil and cisplatin has been considered a preferred combination regimen with ongoing debate as to the benefit of triplet therapy with either an epirubicin or docetaxel. Other agents such as oxaliplatin and capecitabine showed non-inferiority or less toxic results, positioning them as valuable alternatives to cisplatin and fluorouracil. In second-line chemotherapy, single-agent irinotecan or docetaxel was proven to be superior to best supportive care. In gastric cancer, an increasing number of clinical trials have been initiated and completed using targeted therapies. Recently the phase III Trastuzumab for Gastric Cancer study has shown an increase in overall survival for patients with human HER-2 positive gastric cancer treated with chemotherapy and trastuzumab compared to chemotherapy alone. Other new targeted agents may show promising results in phase II trials, but further phase III trial are needed. Future studies should address how to better select patients for new, targeted agents.

Keyword

Chemotherapy; Cancer of stomach; Molecular targeted therapy

MeSH Terms

Antibodies, Monoclonal, Humanized
Camptothecin
Cisplatin
Deoxycytidine
Drug Therapy, Combination
Epirubicin
Fluorouracil
Humans
Molecular Targeted Therapy
Organoplatinum Compounds
Stomach Neoplasms
Taxoids
Capecitabine
Trastuzumab
Antibodies, Monoclonal, Humanized
Camptothecin
Cisplatin
Deoxycytidine
Epirubicin
Fluorouracil
Organoplatinum Compounds
Taxoids