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Updates on Chemotherapy for Advanced Gastric Cancer
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Updates on Chemotherapy for Advanced Gastric Cancer

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 10414

Special Issue Editors

Dr. Yasushi Tsuji

E-Mail Website
Guest Editor
Department of Medical Oncology, Tonan Hospital, Sapporo, Japan
Interests: gastrointestinal cancer; breast cancer; chemotherapy; intraperitoneal chemotherapy; conversion surgery
Prof. Dr. Yasushi Sato

E-Mail Website
Guest Editor
Department of Community Medicine for Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
Interests: cancer genomic medicine; gastroenterology; exosome; miRNA; conversion therapy; clinical oncology

Special Issue Information

Dear Colleagues,

Gastric cancer (GC) is the fifth most common cancer worldwide and the third leading cause of cancer-related death. The incidence shows large geographical variations, with high-risk regions including East Asia, Eastern Europe, and Central and South America. The five-year survival rate is relatively poor, from 10% to 30%, except in Japan and Korea, where early diagnosis by endoscopic examination and consecutive early tumor resection are prevalent. Most symptomatic GC patients are in an advanced stage, so the development of effective standard chemotherapy for GC remains an urgent and important issue.

In the last twenty years, a large number of new drugs, not only cytotoxic but also targeting agents, has been developed thanks to the advancement of basic research, and these drugs have significantly improved the prognosis of various cancers, including GC. Most recently, clinical application of immune checkpoint inhibitors has dramatically changed treatment strategies.

GC patients with peritoneal metastases, however, keep seeing poor outcomes mainly because of low penetration of intravenously administered drugs (even novel agents) into the peritoneal cavity. Intraperitoneal chemotherapy with Paclitaxel, which has been recently developed, is one of the potential breakthrough therapies for GC patients with peritoneal metastases.

GC is a relatively heterogeneous disease requiring individually optimized treatment approach. The aim of this Special Issue is to present updated treatment strategies for various types of GC in a carefully curated collection of original and review papers.

Topics include but are not limited to:

  • Updated chemotherapy for gastric cancer;
  • Updated treatment for HER2-positive gastric cancer;
  • Updated immunotherapy for gastric cancer;
  • The role of VEGF/VEGFR inhibitors in gastric cancer;
  • Intraperitoneal chemotherapy for gastric cancer with peritoneal metastases;
  • Optimal chemotherapy in elderly patients with gastric cancer;
  • Updated adjuvant chemotherapy for gastric cancer;
  • Novel biomarkers of gastric cancer: current research and future perspectives.

Dr. Yasushi Tsuji
Prof. Dr. Yasushi Sato
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastric cancer
  • chemotherapy
  • HER2
  • immunotherapy
  • VEGF
  • peritoneal metastases
  • elderly patients
  • adjuvant chemotherapy
  • biomarkers

Published Papers (4 papers)

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Review

16 pages, 314 KiB  
Review
History and Future of HER2-Targeted Therapy for Advanced Gastric Cancer
by Shin Ariga
J. Clin. Med. 2023, 12(10), 3391; https://doi.org/10.3390/jcm12103391 - 10 May 2023
Cited by 1 | Viewed by 2053
Abstract
Human epidermal growth factor receptor 2 (HER2) is a receptor tyrosine kinase that belongs to the human epidermal growth factor receptor family. It is overexpressed/amplified in approximately 20% of gastric or gastroesophageal junction cancers. HER2 is being developed as a therapeutic target in [...] Read more.
Human epidermal growth factor receptor 2 (HER2) is a receptor tyrosine kinase that belongs to the human epidermal growth factor receptor family. It is overexpressed/amplified in approximately 20% of gastric or gastroesophageal junction cancers. HER2 is being developed as a therapeutic target in a variety of cancers, and several agents have been shown to be effective in breast cancer. The development of HER2-targeted therapy for gastric cancer successfully began with trastuzumab. However, while effective in breast cancer, the successive anti-HER2 agents lapatinib, T-DM1, and pertuzumab failed to demonstrate benefits regarding survival in gastric cancer compared with the existing standard therapies. Intrinsic differences lie between gastric and breast cancer in terms of HER2-positive tumor biology, which may make development difficult. Recently, a novel anti-HER2 agent, trastuzumab deruxtecan, was introduced, and the development of HER2-positive gastric cancer agents has been moving to the next stage. This review summarizes the current HER2-targeted therapy for gastric or gastroesophageal cancer in chronological order and describes the promising future of HER2-targeted therapy. Full article
(This article belongs to the Special Issue Updates on Chemotherapy for Advanced Gastric Cancer)
21 pages, 1828 KiB  
Review
The Role of Angiogenesis Targeted Therapies in Metastatic Advanced Gastric Cancer: A Narrative Review
by Izuma Nakayama and Daisuke Takahari
J. Clin. Med. 2023, 12(9), 3226; https://doi.org/10.3390/jcm12093226 - 30 Apr 2023
Cited by 3 | Viewed by 2055
Abstract
Since bevacizumab was first approved by the U.S. Food and Drug Administration as an anti-angiogenic therapy in 2004, angiogenesis-targeted therapy has been developed for various types of solid tumors. To date, ramucirumab and apatinib are clinically available as treatments for metastatic advanced gastric [...] Read more.
Since bevacizumab was first approved by the U.S. Food and Drug Administration as an anti-angiogenic therapy in 2004, angiogenesis-targeted therapy has been developed for various types of solid tumors. To date, ramucirumab and apatinib are clinically available as treatments for metastatic advanced gastric cancer (AGC). Ramucirumab demonstrated prolonged survival as second-line therapy of metastatic AGC in the RAINBOW and REGARD trials. However, neither ramucirumab extended survival in treatment-naïve patients with AGC in the RAINFALL or RAINSTORM trials nor bevacizumab in the AVAGAST and AVATAR trials. Apatinib demonstrated superior efficacy over the best supportive care in a Chinese phase III trial but not in an international phase III (ANGEL) trial. Currently, combination therapy of ramucirumab with irinotecan or FTD/TPI is being evaluated in the third-line setting, assessing the efficacy of continuous angiogenesis inhibition from second- to third-line therapy. Recently, the role of angiogenesis inhibition via immunomodulators is attractive to clinicians. Emerging results of several early-phase clinical trials indicated the promising antitumor activity of angiogenesis inhibition in combination with immune therapy. This review offers an overview of the history of clinical trials focused on anti-angiogenic for patients with AGC and presents future perspectives in this area. Full article
(This article belongs to the Special Issue Updates on Chemotherapy for Advanced Gastric Cancer)
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23 pages, 4702 KiB  
Review
Updated Immunotherapy for Gastric Cancer
by Yukiya Narita and Kei Muro
J. Clin. Med. 2023, 12(7), 2636; https://doi.org/10.3390/jcm12072636 - 01 Apr 2023
Cited by 6 | Viewed by 3276
Abstract
Gastric cancer treatments are evolving rapidly. For example, immune checkpoint inhibitors, especially those that target PD-1 or PD-L1, have long-term efficacy in a subset of gastric cancer patients, and are currently the first-line therapy. Immunotherapies approved for use in untreated gastric cancer patients [...] Read more.
Gastric cancer treatments are evolving rapidly. For example, immune checkpoint inhibitors, especially those that target PD-1 or PD-L1, have long-term efficacy in a subset of gastric cancer patients, and are currently the first-line therapy. Immunotherapies approved for use in untreated gastric cancer patients include monotherapy and chemotherapy-immunotherapy combinations. Major clinical trials have reported efficacy and safety data suggesting that PD-L1 expression is important for regimen selection, although other biomarkers, clinicopathologic factors, and patient preference might also be relevant in other situations. Currently, several novel biomarkers and therapeutic strategies are being assessed, which might refine the current treatment paradigm. In this review, we describe the current treatment regimens for patients with gastric cancer and detail the approach we use for the selection of first-line immunotherapy regimens. Full article
(This article belongs to the Special Issue Updates on Chemotherapy for Advanced Gastric Cancer)
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Figure 1

15 pages, 827 KiB  
Review
Overview of Chemotherapy for Gastric Cancer
by Yasushi Sato, Koichi Okamoto, Yoshifumi Kida, Yasuhiro Mitsui, Yutaka Kawano, Masahiro Sogabe, Hiroshi Miyamoto and Tetsuji Takayama
J. Clin. Med. 2023, 12(4), 1336; https://doi.org/10.3390/jcm12041336 - 07 Feb 2023
Cited by 10 | Viewed by 2552
Abstract
Gastric cancer (GC) is one of the most clinically challenging cancers worldwide. Over the past few years, new molecular-targeted agents and immunotherapy have markedly improved GC prognosis. Human epidermal growth factor receptor 2 (HER2) expression is a key biomarker in first-line chemotherapy for [...] Read more.
Gastric cancer (GC) is one of the most clinically challenging cancers worldwide. Over the past few years, new molecular-targeted agents and immunotherapy have markedly improved GC prognosis. Human epidermal growth factor receptor 2 (HER2) expression is a key biomarker in first-line chemotherapy for unresectable advanced GC. Further, the addition of trastuzumab to cytotoxic chemotherapy has extended the overall survival of patients with HER2-positive advanced GC. In HER2-negative GC, the combination of nivolumab, an immune checkpoint inhibitor, and a cytotoxic agent has been demonstrated to prolong the overall survival of GC patients. Ramucirumab and trifluridine/tipiracil, which are second- and third-line treatments for GC, and trastuzumab deruxtecan, an antibody–drug conjugate for HER2-positive GC, have been introduced in clinics. New promising molecular-targeted agents are also being developed, and combination therapy comprising immunotherapy and molecular-targeted agents is expected. As the number of available drugs increases, it is important to understand the target biomarkers and drug characteristics and select the optimal therapy for each patient. For resectable disease, differences in the extent of standard lymphadenectomy between Eastern and Western countries have led to different standard treatments: perioperative (neoadjuvant) and adjuvant therapy. This review aimed to summarize recent advances in chemotherapy for advanced GC. Full article
(This article belongs to the Special Issue Updates on Chemotherapy for Advanced Gastric Cancer)
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