Published online Oct 14, 2013. doi: 10.3748/wjg.v19.i38.6383
Revised: July 24, 2013
Accepted: August 5, 2013
Published online: October 14, 2013
Globally, gastric cancer is the 4th most frequently diagnosed cancer and the 2nd leading cause of death from cancer, with an estimated 990000 new cases and 738000 deaths registered in 2008. In the advanced setting, standard chemotherapies protocols acquired an important role since last decades in prolong survival. Moreover, recent advances in molecular therapies provided a new interesting weapon to treat advanced gastric cancer through anti-human epidermal growth factor receptor 2 (HER2) therapies. Trastuzumab, an anti-HER2 monoclonal antibody, was the first target drug in the metastatic setting that showed benefit in overall survival when in association with platinum-5-fluorouracil based chemotherapy. Further, HER2 overexpression analysis acquired a main role in predict response for trastuzumab in this field. Thus, we conducted a review that will discuss the main points concerning trastuzumab and HER2 in gastric cancer, providing a comprehensive overview of molecular mechanisms and novel trials involved.
Core tip: Advanced gastric cancer is a very aggressive disease thought the standard chemotherapy protocols available. In 2010, Trastuzumab for Gastric Cancer trial showed that the combination of trastuzumab, could be considered a new standard option for patients with human epidermal growth factor receptor 2 (HER2) positive advanced gastric and gastro-esophageal junction cancer. Thus, a new era emerged for those patients due to the interesting possibility in prolong survival in a personalized setting (HER2 positive). Our manuscript will provide an overview of the molecular mechanisms involved and also promising targeted therapies in this field.