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World J Gastroenterol. Oct 28, 2014; 20(40): 14537-14558
Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14537
Clinical management of advanced gastric cancer: The role of new molecular drugs
Ferdinando De Vita, Natale Di Martino, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Luigi Marano, Annamaria Auricchio, Gennaro Galizia, Fortunato Ciardiello, Michele Orditura
Ferdinando De Vita, Alessio Fabozzi, Maria Maddalena Laterza, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Valentina Gambardella, Vincenzo Sforza, Fortunato Ciardiello, Michele Orditura, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy
Natale Di Martino, Luigi Marano, VIII General and Gastrointestinal Surgery, School of Medicine, Second University of Naples School of Medicine, 80138 Naples, Italy
Annamaria Auricchio, Gennaro Galizia, Divisions of Surgical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, 80131 Naples, Italy
Author contributions: All the authors contributed equally to this manuscript.
Correspondence to: Dr. Ferdinando De Vita, MD, PhD, Assistant Professor of Oncology, Division of Medical Oncology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, c/o II Policlinico, Edificio 3, Via Pansini 5, 80131 Naples, Italy. ferdinando.devita@unina2.it
Telephone: +39-81-5666713 Fax: +39-81-5666732
Received: October 29, 2013
Revised: February 19, 2014
Accepted: June 2, 2014
Published online: October 28, 2014
Abstract

Gastric cancer is the fourth most common malignant neoplasm and the second leading cause of death for cancer in Western countries with more than 20000 new cases yearly diagnosed in the United States. Surgery represents the main approach for this disease but, notwithstanding the advances in surgical techniques, we observed a minimal improvement in terms of overall survival with a significant increasing of relapsing disease rates. Despite the development of new drugs has significantly improved the effectiveness of chemotherapy, the prognosis of patients with unresectable or metastatic gastric adenocarcinoma remains poor. Recently, several molecular target agents have been investigated; in particular, trastuzumab represents the first target molecule showing improvements in overall survival in human epithelial growth factor 2-positive gastric cancer patients. New molecules targeting vascular epithelial growth factor, mammalian target of rapamycin, and anti hepatocyte growth factor-c-Met pathway are also under investigation, with interesting results. Anyway, it seems necessary to select more accurately the population to treat with new agents by the identification of new biomarkers in order to optimize the results. In this paper we review the actual “scenario” of targeted treatments, also focusing on the new agents in development for gastric cancer and gastro-esophageal carcinoma, discussing their efficacy and potential applications in clinical practice.

Keywords: Advanced gastric cancer, Gastrointestinal cancer, Targeted therapy, Monoclonal antibodies, Tyrosine-kinase inhibitor, Gastric cancer

Core tip: In this article we review the actual “scenario” of targeted treatments in advanced gastric cancer, also focusing on the new agents in development,discussing their efficacy and potential applications in clinical practice.