J.Jpn. Surg. Soc.. 124(5): 398-403, 2023

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CHEMOTHERAPY FOR GASTRIC CANCER

The prognosis for advanced gastric cancer patients is still poor, although multidisciplinary treatment strategies have been developed. Surgery is the main treatment for resectable advanced gastric cancer, but clinical trials have revealed that improvement of prognosis after extended surgery is limited. However, the development of perioperative adjuvant therapy is expected to improve patient prognosis. For unresectable/recurrent gastric cancer, molecular-targeted agents and immune checkpoint inhibitors have been developed, contributing to prolongation of survival. In addition, there are increasing numbers of cases in which long-term survival can be achieved after radical resection due to the disappearance of noncurative factors. As the number of treatment regimen options increases with the development of new drugs, the selection of the appropriate regimen, management of adverse events, and timely switching to posttreatment protocols are becoming important issues. To clarify these issues, it is expected that appropriate patient selection will be promoted by identifying biomarkers, and the practice of precision medicine will be accelerated in the field of gastric cancer treatment in the future. Amid the paradigm shift in gastric cancer treatment, it is important for surgeons to acquire the latest knowledge of cancer drug therapy and biomolecular knowledge of gastric cancer.

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