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World J Gastroenterol. Oct 14, 2014; 20(38): 13741-13755
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.13741
Molecular targeting to treat gastric cancer
Keishiro Aoyagi, Kikuo Kouhuji, Junya Kizaki, Taro Isobe, Kousuke Hashimoto, Kazuo Shirouzu
Keishiro Aoyagi, Kikuo Kouhuji, Junya Kizaki, Taro Isobe, Kousuke Hashimoto, Kazuo Shirouzu, Department of Surgery, Kurume University School of Medicine, Fukuoka 830-0011, Japan
Author contributions: Aoyagi K contributed to management of the research, responsible for writing and revising the full text this review article; Kizaki J, Isobe T and Hashimoto K contributed to analysis of data and clinical work; all authors revised this paper finally.
Correspondence to: Keishiro Aoyagi, MD, PhD, Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan. keishiro@med.kurume-u.ac.jp
Telephone: +81-942-353311 Fax: +81-942-340709
Received: October 27, 2013
Revised: January 13, 2014
Accepted: May 23, 2014
Published online: October 14, 2014
Abstract

Trastuzumab that targets human epidermal growth factor receptor 2 (HER2) protein is the only approved molecular targeting agent for treating gastric cancer in Japan and the outcomes have been favorable. However, trastuzumab is effective for only 10% to 20% of the population with gastric cancer that expresses HER2 protein. Molecular targeting therapy with bevacizumab against vascular endothelial growth factors (VEGF) and with cetuximab and panitumumab against the epidermal growth factors pathway that have been approved for treating colorectal cancer are not considered effective for treating gastric cancer according to several clinical trials. However, ramucirumab that targets VEGF receptor-2 prolonged overall survival in a large phase III clinical trial and it might be an effective molecular targeting therapy for gastric cancer. The significance of molecular targeting therapy for gastric cancer remains controversial. A large-scale randomized clinical trial of novel molecular targeting agents with which to treat gastric cancer is needed.

Keywords: Gastric cancer, Molecular targeting therapy, Human epidermal growth factor receptor 2 protein, Vascular endothelial growth factors/Vascular endothelial growth factor receptor pathway, Epidermal growth factors pathway

Core tip: So far, trastuzumab is the only molecular targeting therapy that has been approved for treating gastric cancer. The significance of molecular targeting therapy for gastric cancer remains controversial, but large scale randomized clinical trials might confirm the benefits of other novel molecular targeting therapies for gastric cancer in the near future.