Chemotherapy of Advanced Gastric Cancer

Jung, Jin Tae

doi:2013.13.3.142

Korean J Helicobacter Up Gastrointest Res > Volume 13(3); 2013 > Article

Review

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2013;13(3):142-146.
DOI: https://doi.org/10.7704/kjhugr.2013.13.3.142 Published online September 10, 2013.

Chemotherapy of Advanced Gastric Cancer

Jin Tae Jung

Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. jungjt@cu.ac.kr

진행성 위암의 항암요법

정진태

대구가톨릭대학교 의과대학 내과학교실

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.

Key Words: Chemotherapy; Cancer of stomach; Molecular targeted therapy