title: Targeted therapy in gastric cancer.
abstract: BACKGROUND
  Gastric cancer is the fourth most common cancer worldwide. Surgery in combination with multimodal therapy provides the only curative therapy until now. The importance of targeted therapy became clear over the last few years. Due to the implication of HER2 and angiogenesis-directed targeted therapies major advances in the treatment of gastric cancer could be reached. Nevertheless, benefits in survival remain unsatisfactory and the development of resistance to monoclonal antibodies is arising.
  
  
  METHODS
  A comprehensive and comparative literature research was performed to evaluate the status of HER2 and angiogenesis-directed targeted therapy in gastric cancer.
  
  
  RESULTS
  Up to now, trastuzumab and ramucirumab are the only agents showing remarkable benefits in the therapy for the patients suffering from gastric cancer. The limitations of targeted therapies in gastric cancer are mainly associated with the development of secondary resistance.
  
  
  CONCLUSIONS
  Addition of targeted therapy in second-line treatment is beneficial when compared with chemotherapy alone. Nevertheless, results in first-line treatment remain modest. Therefore, new therapeutic agents and combinations in the first-line treatment of gastric cancer are urgently needed and remain to be validated in clinical trials.
authors: Department of Surgery, Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
authors: G
authors: G
authors: Jomrich
authors: Department of Surgery, Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
authors: S F
authors: SF
authors: Schoppmann
keywords: Angiogenesis; Chemo-resistance; Gastric cancer; HER2; Ramucirumab; Targeted therapy; Trastuzumab