title: Clinical management of advanced gastric cancer: the role of new molecular drugs.
abstract: Gastric cancer is the fourth most common malignant neoplasm and the second leading cause of death for cancer in Western countries with more than 20000 new cases yearly diagnosed in the United States. Surgery represents the main approach for this disease but, notwithstanding the advances in surgical techniques, we observed a minimal improvement in terms of overall survival with a significant increasing of relapsing disease rates. Despite the development of new drugs has significantly improved the effectiveness of chemotherapy, the prognosis of patients with unresectable or metastatic gastric adenocarcinoma remains poor. Recently, several molecular target agents have been investigated; in particular, trastuzumab represents the first target molecule showing improvements in overall survival in human epithelial growth factor 2-positive gastric cancer patients. New molecules targeting vascular epithelial growth factor, mammalian target of rapamycin, and anti hepatocyte growth factor-c-Met pathway are also under investigation, with interesting results. Anyway, it seems necessary to select more accurately the population to treat with new agents by the identification of new biomarkers in order to optimize the results. In this paper we review the actual "scenario" of targeted treatments, also focusing on the new agents in development for gastric cancer and gastro-esophageal carcinoma, discussing their efficacy and potential applications in clinical practice.
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: De Vita
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Natale
authors.initials: N
authors.lastname: Di Martino
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Fabozzi
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Maria Maddalena
authors.initials: MM
authors.lastname: Laterza
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Jole
authors.initials: J
authors.lastname: Ventriglia
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Savastano
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Angelica
authors.initials: A
authors.lastname: Petrillo
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Gambardella
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Sforza
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Marano
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Auricchio
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Galizia
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Fortunato
authors.initials: F
authors.lastname: Ciardiello
authors.affiliation: Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Orditura
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000037:antagonists & inhibitors* / Q000378:metabolism; D006801:Humans; D058990:Molecular Targeted Therapy; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D015398:Signal Transduction / Q000187:drug effects; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D047428:Protein Kinase Inhibitors
keywords: Advanced gastric cancer; Gastric cancer; Gastrointestinal cancer; Monoclonal antibodies; Targeted therapy; Tyrosine-kinase inhibitor