Evolving Chemotherapy for Advanced Gastric Cancer

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Identify the current standard of care and new chemotherapy options for patients with advanced gastric cancer.Discuss recently reported results of phase II and phase III randomized trials of chemotherapy for the treatment of advanced gastric cancer.Outline the clinical implications of recent clinical trial findings and future treatment strategies.Describe regimens that have quality-of-life benefits for patients with advanced gastric cancer and how patients should be selected and managed appropriately. Access and take the CME test online and receive 1 AMA PRA category 1 credit at CME.TheOncologist.com Gastric cancer is the fourth most commonly diagnosed cancer and is the second leading cause of cancer death worldwide. More than 50% of patients undergo surgery, but even after a curative resection, 60% of patients relapse locally or with distant metastases. Despite the fact that many advances have occurred in the management of gastric cancer, it continues to carry a poor prognosis, amplifying the importance of palliative chemotherapy. When compared with best supportive care alone, combination chemotherapy yields a significant advantage in the management of advanced gastric cancer. However, no single regimen has emerged or been accepted as clearly superior over another. Numerous phase II studies have demonstrated promising results with newer agents including irinotecan, docetaxel, capecitabine, S-1, and oxaliplatin. Recently reported phase III results with these agents now demonstrate positive developments in the treatment options for patients with advanced gastric cancer.