Current strategies in systemic treatment of gastric cancer and cancer of the gastroesophageal junction

Abstract

Gastric cancer is a major health issue and a leading cause of death worldwide. The results of standard therapy remain unsatisfactory mainly because of diagnosis at the late stage of disease. Innovative strategies such as neoadjuvant chemotherapy in locally advanced cancer have improved the outcome even in operable cases. Whether an adjuvant radiochemotherapy is of benefit after curative resection including systematic lymphadenectomy remains yet unclear. Some progress has been made in the palliative setting by introducing new substances. This review examines recent advances in the systemic treatment of gastric and gastroesophageal junction cancer.

Multicenter Phase II Study of Everolimus in Patients With Previously Treated Metastatic Gastric Cancer

“…3 Only surgical resection is curative; however, patients with gastric cancer commonly present with unresectable disease. 4 Even after curative surgical resection, 60% of these patients eventually experience relapse. 5 Systemic chemotherapy has been evaluated extensively in patients with unresectable and recurrent gastric cancer.…”

“…5 Systemic chemotherapy has been evaluated extensively in patients with unresectable and recurrent gastric cancer. 4,5 At present, although fluoropyrimidine-based therapy is used worldwide, there is no globally accepted standard first-line chemotherapy for advanced gastric cancer. In randomized studies, combination chemotherapy regimens including fluorouracil (FU) or its derivatives, taxanes, irinotecan, and platinum derivatives generally achieved median overall survival (OS) times of less than 1 year in the first-line setting.…”

Luteolin induces apoptosis in vitro through suppressing the MAPK and PI3K signaling pathways in gastric cancer

“…Therapy for GC includes surgical resection, radiation and chemotherapy (3). Surgical resection is the curative treatment for patients with early stages of disease.…”

Mesogastrium: A fifth route of metastasis in gastric cancer?

“…The radical gastrectomy sweeps away primary lesions, adjacent invaded tissues or organs and metastatic lymph nodes, thus theoretically, local-regional recurrence should be prevented. However, at present, local-regional recurrence of gastric cancer is often noted after radical gastrectomy with D2 lymph node dissection for gastric cancer [3][4][5][6][7]. In fact, about 75-80% of cases still end up with local-regional recurrence in 2 years after the surgery [8].…”