title: Management of advanced gastric cancer.
abstract: The management of advanced gastric cancer has only evolved a little over the last 15 years: platinum and fluoropyrimidine chemotherapy remains the backbone of therapy with ongoing debate as to the benefit of triplet therapy with either an anthracycline or taxane. Recently published trials of biological agents, in particular those targeting the Her2 receptor, have provided some signs of improvement. This article summarizes the relevant literature, discusses the role of these agents, as well as geographical variations in use, and provides recommendations regarding both 'standard chemotherapy' and the role of biological agents in advanced gastric cancer. Given the relative lack of progress for gastric cancer over the last 15 years, the focus for the next 5 years should be on an improved understanding of the molecular basis of gastric cancer, thus allowing rational integration of new molecular agents.
authors.affiliation: Haematology Oncology Unit, The Queen Elizabeth Hospital, Woodville Rd, Woodville, SA 5011, Australia. timothy.price@health.sa.gov.au
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Price
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Shapiro
authors.forename: Eva
authors.initials: E
authors.lastname: Segelov
authors.forename: Christos S
authors.initials: CS
authors.lastname: Karapetis
authors.forename: Nick
authors.initials: N
authors.lastname: Pavlakis
authors.forename: Eric
authors.initials: E
authors.lastname: Van Cutsem
authors.forename: Manish A
authors.initials: MA
authors.lastname: Shah
authors.forename: Yoon-Koo
authors.initials: YK
authors.lastname: Kang
authors.forename: Niall C
authors.initials: NC
authors.lastname: Tebbutt
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006801:Humans; D058990:Molecular Targeted Therapy; D017410:Practice Guidelines as Topic; D015398:Signal Transduction / Q000187:drug effects; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents