title: Positioning of second-line treatment for advanced gastric and gastroesophageal junction adenocarcinoma.
abstract: Tumors of the upper gastrointestinal tract are increasing in incidence; yet, approaches to the treatment of advanced gastric and/or gastroesophageal junction cancer vary widely, with no internationally agreed first-line regimens. Recent clinical trials have shown that second-line treatment is now possible for selected patients with advanced disease, and current data suggest that the combination of ramucirumab plus paclitaxel may become a standard of care in the second-line setting for metastatic gastric cancer. Several prognostic factors have been identified for overall survival in the second-line setting; this emphasizes the need for careful sequencing of all treatments to ensure that individual patients receive optimum care. This article reviews published data on the treatment of advanced gastric cancer, with a particular emphasis on second-line chemotherapy, and suggests treatment sequences based on current understanding.
authors: Department of Oncology, Sabadell University Hospital, Parc Tauli, Sabadell, Spain.
authors: Carles
authors: C
authors: Pericay
authors: Department of Medical Oncology, Hospital Universitario Santander, Santander, Spain.
authors: Fernando
authors: F
authors: Rivera
authors: Gastrointestinal Cancer and Early Clinical and Translational Research Units, 12 de Octubre University Hospital, Madrid, Spain.
authors: Carlos
authors: C
authors: Gomez-Martin
authors: Eli Lilly and Company, Alcobendas, Madrid, Spain.
authors: Inmaculada
authors: I
authors: Nuñez
authors: Eli Lilly and Company, Alcobendas, Madrid, Spain.
authors: Alejo
authors: A
authors: Cassinello
authors: Eli Lilly and Company, Alcobendas, Madrid, Spain.
authors: Esteban Rodrigo
authors: ER
authors: Imedio
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D004943:Esophagogastric Junction / Q000473:pathology*; D006801:Humans; D019233:Retreatment; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D016896:Treatment Outcome
keywords: Adenocarcinoma; gastric cancer; paclitaxel; ramucirumab; treatment