Targeted therapy for advanced gastric cancer: A review of current status and future prospects

Abstract

In the West in particular, the vast majority of gastric cancer (GC) patients present with advanced-stage disease. Although combination chemotherapy is still the most important component of treatment for these patients, it confers a modest survival advantage. Recently, increased knowledge of the key molecular signaling pathways involved in gastric carcinogenesis has led to the discovery of specific molecular-targeted therapeutic agents. Some of these agents such as trastuzumab and ramucirumab have changed the treatment paradigm for this disease. In this paper, we will summarize the current clinical status of targeted drug therapy in the management of GC.

Keywords: Angiogenesis; Epidermal growth factor; Gastric cancer; Targeted therapy; Treatment.

Figures

Figure 1

Molecular targets and relevant drugs in metastatic gastric cancer. HER: Human epidermal growth factor receptor; VEGF: Vascular endothelial growth factor; VEGFR: Vascular endothelial growth factor receptor; PDGFR: Platelet-derived growth factor receptor; HGF: Hepatocyte growth factor; FGFR2: Fibroblast growth factor receptor 2; IGF-1: Insulin-like growth factor 1; Raf: GTPase Raf; Ras: GTPase Ras; MEK: MAP kinase; ERK: Extracellular-signal-regulated kinase; PI3K: Phosphatidylinositol 3-kinase; PTEN: Phosphatase and tensin homolog; AKT: Protein kinase B; mTOR: Mammalian target of rapamycin.

Figure 2

Proposed targeted therapy algorithm for advanced gastric cancer. CF: Cisplatin plus 5-Fluorouracil; HER: Human epidermal growth factor receptor; CX: Cisplatin plus capecitabine.