title: Systemic treatment of gastric cancer.
abstract: Treatment of gastric cancer is improved over the past years, but unanswered questions remain regarding the efficacy of systemic treatments in adjuvant, neoadjuvant and metastatic setting. It has not been definitively demonstrated the efficacy of adjuvant chemotherapy, that should not be adopted as a standard approach to localized gastric cancer. On the contrary, compelling evidence in support of perioperative chemotherapy with ECF regimen has been recently provided by the MAGIC trial, although many criticisms have been moved to this study. For metastatic setting, a recent meta-analysis showed a small, but significant survival benefit for combination vs single agent chemotherapy, and the V-325 trial demonstrated the superiority of a docetaxel containing regimen (DCF) over a doublet (CF). Finally, the results of ongoing clinical trials on a number of new molecular-targeted drugs should confirm their role in gastric cancer.
authors.affiliation: Clinical Trials Unit, National Cancer Institute, Via Mariano Semmola, 80131 Naples, Italy. alessandromorabito1@virgilio.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Morabito
authors.forename: Guido
authors.initials: G
authors.lastname: Carillio
authors.forename: Raffaele
authors.initials: R
authors.lastname: Longo
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D018797:Cell Cycle Proteins / Q000378:metabolism; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D066246:ErbB Receptors / Q000378:metabolism; D006801:Humans; D020782:Matrix Metalloproteinases / Q000378:metabolism; D020360:Neoadjuvant Therapy / Q000706:statistics & numerical data; D009389:Neovascularization, Pathologic / Q000378:metabolism; D046988:Proteasome Endopeptidase Complex / Q000378:metabolism; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D013274:Stomach Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D018797:Cell Cycle Proteins; D004791:Enzyme Inhibitors; D066246:ErbB Receptors; D020782:Matrix Metalloproteinases; D046988:Proteasome Endopeptidase Complex; D018719:Erb-b2 Receptor Tyrosine Kinases