title: Unmet needs and challenges in gastric cancer: the way forward.
abstract: Although the incidence of gastric cancer has fallen steadily in developed countries over the past 50 years, outcomes in Western countries remain poor, primarily due to the advanced stage of the disease at presentation. While earlier diagnosis would help to improve outcomes for patients with gastric cancer, better understanding of the biology of the disease is also needed, along with advances in therapy. Indeed, progress in the treatment of gastric cancer has been limited, mainly because of its genetic complexity and heterogeneity. As a result, there is an urgent need to apply precision medicine to the management of the disease in order to ensure that individuals receive the most appropriate treatment. This article suggests a number of strategies that may help to accelerate progress in treating patients with gastric cancer. Incorporation of some of these approaches could help to improve the quality of life and survival for patients diagnosed with the disease. Standardisation of care across Europe through expansion of the European Registration of Cancer Care (EURECCA) registry - a European cancer audit that aims to improve quality and decrease variation in care across the region - may also be expected to lead to improved outcomes for those suffering from this common malignancy.
authors.affiliation: University Cancer Center Leipzig (UCCL), University Clinic Leipzig, Leipzig, Germany. Electronic address: florian.lordick@medizin.uni-leipzig.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Lordick
authors.affiliation: Department of Surgery, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom. Electronic address: william.allum@rmh.nhs.uk.
authors.forename: William
authors.initials: W
authors.lastname: Allum
authors.affiliation: IPATIMUP and Medical Faculty/Centro Hospitalar de São João, Porto, Portugal. Electronic address: fcarneiro@ipatimup.pt.
authors.forename: Fátima
authors.initials: F
authors.lastname: Carneiro
authors.affiliation: Department of Medical Oncology, Institut Curie and EA4340, Faculty of Medicine, University of Versailles St-Quentin, Paris, France. Electronic address: emmanuel.mitry@curie.net.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mitry
authors.affiliation: Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: jtabernero@vhio.net.
authors.forename: Josep
authors.initials: J
authors.lastname: Tabernero
authors.affiliation: Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School and Genome Institute of Singapore, Singapore. Electronic address: gmstanp@duke-nus.edu.sg.
authors.forename: Patrick
authors.initials: P
authors.lastname: Tan
authors.affiliation: Digestive Oncology, University Hospitals and KU Leuven, Leuven, Belgium. Electronic address: eric.vancutsem@uzleuven.be.
authors.forename: Eric
authors.initials: E
authors.lastname: Van Cutsem
authors.affiliation: Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: c.j.h.van_de_velde@lumc.nl.
authors.forename: Cornelis
authors.initials: C
authors.lastname: van de Velde
authors.affiliation: Biomedical Research Institute IINCLIVA, University of Valencia, Valencia, Spain. Electronic address: andres.cervantes@uv.es.
authors.forename: Andrés
authors.initials: A
authors.lastname: Cervantes
mesh_terms: D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003695:Delivery of Health Care / Q000592:standards / Q000639:trends; D015195:Drug Design; D005060:Europe / Q000453:epidemiology; D005743:Gastrectomy; D023281:Genomics; D006801:Humans; D058990:Molecular Targeted Therapy / Q000379:methods / Q000639:trends; D011786:Quality Control; D011787:Quality of Health Care; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics / Q000601:surgery / Q000628:therapy*
keywords: Drug development; Gastric cancer; Heterogeneity; Pathogenesis; Treatment