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Chemotherapy in the Treatment of Metastatic Gastric Cancer: Is There a Global Standard?

  • Esophageal and Gastric Cancer
  • Published:
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Opinion statement

Gastric cancer remains one of the leading causes of cancer mortality worldwide even though its incidence has been decreasing in recent years. Despite remarkable advancements in chemotherapy, advanced gastric cancer has remained a therapeutic challenge for physicians as well as for patients. While early chemotherapeutic regimens succeeded in showing a modest but definite improvement over best supportive care, no single regimen stood out as superior. Most early trials failed to show survival benefit of combination regimens over single agent fluorouracil, but combination regimens were shown to have better response rates. Based on these data, the Japanese adopted single agent fluorouracil as a reference standard for further investigations, while the rest of the world used a doublet containing fluorouracil and platinum. As more clinical trials were conducted, the Japanese standard evolved into a doublet, while the Western countries adopted triplet combinations. There is no established global standard as yet, but with the introduction of newer targeted agents based on molecular assays and personalized approaches combined with conventional chemotherapy, multiple regimens are likely to emerge as global standards rather than one standard treatment for all.

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Disclosure

Dr. Kauh has received money paid to him for consultancy with Bayer Pharmaceuticals and Onyx Pharmaceuticals. No other potential conflicts of interest relevant to this article were reported.

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  1. Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, 1365-C Clifton Rd NE, Atlanta, GA, 30322, USA

    Hyunseok Kang MD, MPH & John S. Kauh MD

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  1. Hyunseok Kang MD, MPH
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Correspondence to John S. Kauh MD.

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Kang, H., Kauh, J.S. Chemotherapy in the Treatment of Metastatic Gastric Cancer: Is There a Global Standard?. Curr. Treat. Options in Oncol. 12, 96–106 (2011). https://doi.org/10.1007/s11864-010-0135-z

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