Advanced gastric cancer - Slow but steady progress Journal Article
| Authors: | Power, D. G.; Kelsen, D. P.; Shah, M. A. |
| Article Title: | Advanced gastric cancer - Slow but steady progress |
| Abstract: | Progress in gastric cancer has been slow, but steady. Historically, patients commonly presented with significant disease related co-morbidity and received treatment of marginal benefit but unfortunately associated with significant toxicity. Today there is no universally accepted reference standard chemotherapy for this disease. However, there is reason for optimism. Meta-analyses of randomized trials have shown a benefit for first-line combination chemotherapy. Current three drug chemotherapy regimens remain toxic, though perhaps less so than previously, and can result in a small but significant survival advantage in carefully chosen patients. Incremental improvements have been observed in both treatment-related toxicity and survival after first-line therapy. More patients are candidates for chemotherapy beyond progression with first-line therapy and response rates with second-line regimens are similar to those seen in other solid tumor malignancies. Although there is no randomized data to support its use second-line treatment should be considered in appropriate patients. Even before the integration of targeted therapies in the treatment of gastric cancer, it was evident that survival for more than 2 years is possible in a subset of patients and large retrospective studies have highlighted clinicopathologic factors associated with improved survival. Presently, with the addition of targeted therapy, especially anti-angiogenic and anti-Her2 therapy, and a better understanding of the biology of the disease, perhaps a sense of optimism should indeed suppress the nihilism commonly associated with this disease. © 2010. |
| Keywords: | immunohistochemistry; signal transduction; cancer chemotherapy; survival rate; pathogenesis; review; bevacizumab; cisplatin; doxorubicin; fluorouracil; antineoplastic agents; capecitabine; chemotherapy; neoplasm staging; quality of life; incidence; morbidity; epidermal growth factor receptor; docetaxel; irinotecan; appetite; fluorescence in situ hybridization; disease progression; folinic acid; comorbidity; nausea and vomiting; stomach cancer; prognostic index; trastuzumab; oxaliplatin; stomach neoplasms; salvage; digestive system function disorder; gastric cancer; cell adhesion molecule; world health; oncogene neu; nutrition; molecular targets; second-line treatment; catumaxomab |
| Journal Title: | Cancer Treatment Reviews |
| Volume: | 36 |
| Issue: | 5 |
| ISSN: | 0305-7372 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-08-01 |
| Start Page: | 384 |
| End Page: | 392 |
| Language: | English |
| DOI: | 10.1016/j.ctrv.2010.01.005 |
| PUBMED: | 20176443 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: CTRED" - "Source: Scopus" |
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