Adjuvant Therapy for Gastric Cancer

Neoadjuvant therapy of locally advanced gastric cancer

Treatment of gastric cancer has evolved with the advent of randomized trials demonstrating chemotherapeutic agents with efficacy in advanced disease. Level I evidence supports delivering chemotherapy in the neoadjuvant setting; the data shows improvement in progression-free and overall survival. A clinical response to therapy is associated with improved R0 resection rates, pathologic response, and outcome in patients with locally advanced disease. Early assessment of metabolic response to therapy can potentially be utilized to tailor treatment.

Randomized clinical trials in gastric cancer

Minimally invasive resection has emerged as a surgical technique for gastric cancer, and there has been continued investigation to determine the appropriate extent of lymphadenectomy in gastric cancer patients. There has also been significant progress in evaluating the role of chemotherapeutic regimens used in the neoadjuvant and adjuvant settings for patients with resectable disease. We also summarize a selection of RCT trials focused on the perioperative care of the gastric cancer patient.