Update on the Treatment of Gastric Cancer

Abstract

Gastric cancer remains a major health concern worldwide, particularly in Asia. Surgery is the only curative treatment, and D2 gastrectomy is the standard therapy for resectable cases. Several clinical trials have been conducted in Japan to achieve higher cure rates via extended surgery; however, despite higher morbidity, none demonstrated prolonged survival. Against this background, minimally invasive surgical approaches that preserve gastric function and improve postoperative quality of life have been developed in recent years. For early gastric cancer, endoscopic resection and laparoscopic gastrectomy have achieved remarkable success even for later-stage cases. Long-term outcomes have been investigated in large-scale, randomized controlled trials. In addition, robot-assisted gastrectomy is now more common in clinical practice. S-1, an anti-tumor drug, is a key agent for treating gastric cancer and has resulted in dramatic improvements in survival. For locally advanced gastric cancer, patients are usually treated with surgery and adjuvant or neoadjuvant chemotherapy, and the efficacies of various regimens have been examined in many clinical trials. For unresectable or recurrent gastric cancer, new agents such as molecular-targeted agents and immune checkpoint inhibitors have emerged as notable treatments and are now being tested in numerous clinical trials. This review provides an update on gastric cancer treatment, highlighting current individualized strategies and future perspectives.

METTL14-mediated m6A modification of circORC5 suppresses gastric cancer progression by regulating miR-30c-2-3p/AKT1S1 axis

“…Although the incidence and mortality of gastric cancer (GC) present a downward trend worldwide [ 1 ], but GC remains the third leading cause of cancer-related deaths in China [ 2 ]. Recent decades have witnessed the great progress in the treatment of GC including endoscopic resection, targeted therapy, and immunotherapy [ 3 ]. But, the prognosis of advanced patients is still poor owing to tumor invasion and metastasis.…”

Three-Year Outcomes of a Phase II Study of Perioperative Capecitabine Plus Oxaliplatin Therapy for Clinical SS/SE N1-3 M0 Gastric Cancer (OGSG 1601)

“… 4 Although the mainstay of treatment for GC is surgical resection, many patients suffer from recurrent disease. 5-7 Since the prognoses of patients with recurrent GC are still poor, more effective chemotherapy should be developed. At present, perioperative and postoperative chemotherapy improve overall survival in patients with resectable GC.…”

Prediction of genetic alterations from gastric cancer histopathology images using a fully automated deep learning approach

“…Recently, many drugs targeting specific biological molecules have been introduced to improve the survival of patients with advanced GC[ 31 ]. However, patient stratification strategies to maximize the treatment response of these new drugs are not yet well established.…”