title: Preoperative Chemotherapy for Gastric Cancer: Personal Interventions and Precision Medicine.
abstract: In spite of the declining incidence of gastric cancer (GC) in recent years, the mortality rate is still high. The asymptomatic nature and nonspecific clinical manifestations combined with the lack of efficient screening programs delay the diagnosis of GC. Therefore, the prevalence of advanced gastric cancer (AGC) has prompted the need for aggressive and intensive treatment options. Among the various treatment options for AGC, surgery is still the mainstay. However, the efficacy of surgery alone is not established. Results from multiple randomized controlled trials suggest that preoperative chemotherapy is promising intervention for the treatment and management of AGC. The main objective of neoadjuvant chemotherapy is to downstage or control micrometastasis in resectable tumor before surgery. On the other hand, conversion chemotherapy refers to surgical treatment aiming at R0 resection after chemotherapy for originally nonresectable or marginally resectable tumors. Nevertheless, preoperative chemoradiotherapy is considered beneficial for AGC patients. Over the last few decades, the combination of chemotherapy and targeted therapy prior to surgery demonstrated great results for the treatment of AGC. The rapid developments in genomics and proteomics have heralded the era of precision medicine. The combination of preoperative chemotherapy and precision medicine may enhance survival in AGC patients.
authors.affiliation: Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200025, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200025, China.
authors.forename: Maneesh K
authors.initials: MK
authors.lastname: Beeharry
authors.affiliation: Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200025, China.
authors.forename: Wentao
authors.identifier: 0000-0002-2166-8259
authors.initials: W
authors.lastname: Liu
authors.affiliation: Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200025, China.
authors.forename: Min
authors.initials: M
authors.lastname: Yan
authors.affiliation: Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200025, China.
authors.forename: Zhenggang
authors.initials: Z
authors.lastname: Zhu
mesh_terms: D059248:Chemoradiotherapy / Q000379:methods*; D006801:Humans; D009362:Neoplasm Metastasis; D057285:Precision Medicine / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate