title: Second-line chemotherapy for patients with advanced gastric cancer.
abstract: The first choice for treating patients with metastatic gastric cancer is chemotherapy, and combination therapy with fluorouracil, platinum, and trastuzumab has been established as the standard first-line chemotherapy. For further improvement of treatment outcomes, it is important to develop second- and third-line chemotherapy. In the first decade of this century, irinotecan and taxanes, cytotoxic agents, and various molecular targeted agents began to be developed as second-line therapy. Treatment with paclitaxcel weekly in combination with ramucirumab targeting vascular endothelial growth factor receptor 2 has become the first choice for second-line therapy. Immune checkpoint inhibitors are now being developed, and the current treatment strategies for advanced gastric cancer may undergo major changes in the future. This review summarizes the transitions and future prospects of clinical developments for second-line therapy in patients with advanced gastric cancer.
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan. daisuke.takahari@jfcr.or.jp.
authors.forename: Daisuke
authors.identifier: http://orcid.org/0000-0002-2492-6014
authors.initials: D
authors.lastname: Takahari
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology / Q000627:therapeutic use*; D000077143:Docetaxel; D000068338:Everolimus / Q000493:pharmacokinetics; D006801:Humans; D058990:Molecular Targeted Therapy / Q000379:methods*; D017239:Paclitaxel / Q000008:administration & dosage; D000067856:Poly(ADP-ribose) Polymerase Inhibitors / Q000493:pharmacokinetics; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors / Q000276:immunology; D050796:STAT3 Transcription Factor / Q000037:antagonists & inhibitors; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality; D043823:Taxoids / Q000008:administration & dosage; D042461:Vascular Endothelial Growth Factor A / Q000276:immunology / Q000378:metabolism
chemical_list: D000077143:Docetaxel; D000068338:Everolimus; D017239:Paclitaxel; D000067856:Poly(ADP-ribose) Polymerase Inhibitors; D018719:Erb-b2 Receptor Tyrosine Kinases; D050796:STAT3 Transcription Factor; D043823:Taxoids; D042461:Vascular Endothelial Growth Factor A; C494086:STAT3 protein, human; C467484:VEGFA protein, human; C508053:ERBB2 protein, human
keywords: Chemotherapy; Gastric cancer; Irinotecan; Paclitaxel; Ramucirumab