Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2016; 22(20): 4812-4823
Published online May 28, 2016. doi: 10.3748/wjg.v22.i20.4812
Current and emerging therapies in unresectable and recurrent gastric cancer
Erin Jou, Lakshmi Rajdev
Erin Jou, Lakshmi Rajdev, Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, United States
Author contributions: Jou E and Rajdev L contributed equally to this work.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Lakshmi Rajdev, MD, Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, 1695 Eastchester Road, Bronx, NY 10467, United States.
Telephone: +1-718-4058404 Fax: +1-718-4058433
Received: February 25, 2016
Peer-review started: February 25, 2016
First decision: March 31, 2016
Revised: April 8, 2016
Accepted: April 20, 2016
Article in press: April 20, 2016
Published online: May 28, 2016

Gastric cancer is one of the most lethal cancers worldwide despite many advances and options in therapy. As it is often diagnosed at an advanced stage, prognosis is poor with a median overall survival of less than twelve months. Chemotherapy remains the mainstay of treatment for these patients but it confers only a moderate survival advantage. There remains a need for new targeted treatment options and a way to better define patient populations who will benefit from these agents. In the past few years, there has been a better understanding of the biology, molecular profiling, and heterogeneity of gastric cancer. Our increased knowledge has led to the identification of gastric cancer subtypes and to the development of new targeted therapeutic agents. There are now two new targeted agents, trastuzumab and ramucirumab, that have recently been approved for the treatment of advanced and metastatic gastric cancer. There are also many other actively investigated targets, including epidermal growth factor receptor, the phosphatadylinositol 3-kinase/protein kinase B/mammalian target of rapamycin pathway, c-Met, poly ADP-ribose polymerase, and immune checkpoint inhibition. In this review, we discuss the current management of advanced gastric cancer as well as emerging targeted therapies and immunotherapy.

Keywords: Advanced gastric cancer, Immunotherapy, Human epidermal growth factor receptor type 2, Targeted therapy, Vascular endothelial growth factor receptor

Core tip: Despite many advances in medical and surgical treatments, gastric cancer remains the second leading cause of cancer deaths. There is a greater understanding of the molecular heterogeneity of gastric cancer in recent years, resulting in the development and clinical investigation of different targeted agents. This review will discuss current treatment strategies and highlight targeted therapies and emerging drugs for advanced gastric cancer.