Modern treatment of gastric cancer

The incidence of gastric cancer continues to increase. Because the relative poor prognosis and the high death rate associated with gastric and gastro-oesophageal junction (GEJ) cancer, a great effort in research and drug development has been seen in this field to make new and effective medicines available to cancer patients. As a result of these efforts, the treatment options for gastric cancer and gastro-oesophageal junction (GEJ) tumours have improved significantly over the past decade. In this article, we focus mainly on systemic drug treatments and only marginally mention the development of endoscopic and surgical procedures that have contributed to improved outcomes. In the early stages of this disease, the widespread use of perioperative (neoadjuvant and adjuvant) therapy has led to improved surgical resection outcomes, improved rate of complete pathological regression and improved survival outcomes. Survival outcomes for locally advanced, unresectable and metastatic patients have also improved with the introduction of modern targeted and immuno-oncology therapies. Treatment with the HER2 inhibitor trastuzumab, and immuno-oncology agents (nivolumab, pembrolizumab) resulted in significant improvements in progression-free survival (PFS) and overall survival (OS) in the advanced or metastatic patient group. In addition to these efficient drugs we use in our everyday practice, new drugs have been registered in recent years, most of which can be used for certain biomarker conditions.