TITLE:
Perioperative Treatment in Gastric Cancer—Developments in Patient Selection
AUTHORS:
Manuela Machado, Helena Magalhães, Mário Fontes-Sousa
KEYWORDS:
Gastric Cancer, Perioperative Chemotherapy, Molecular Classification of Gastric Cancer, MSI
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.2,
February
2,
2018
ABSTRACT: Gastric cancer (GC) is a major public health issue. It is considered the 5th most common cancer
diagnosed worldwide and it is one of the main causes
of malignant disease-associated morbidity and mortality. The cornerstone of curative
treatment is still surgery, and since the rate of relapse is high, a multidisciplinary
approach is warranted in most developed countries. And while there have been recent
developments in the perioperative scenario namely the FLOT regimen, little has advanced considering
patient selection. We have reviewed the major trials in this setting and
provide some insights from recently
reported microsatellite instability (MSI) in a subgroup analysis in the MAGIC trial patients that seem to
suggest an opportunity to patient selection. Furthermore,
GC subtyping may prove helpful selecting candidates to immunotherapy or even
multimodal therapy in the future. As the paradigm is moving towards a precision
oncology model, GC patient selection
remains one the biggest challenges in oncology but seems closer to clinical
practice reality as new developments are being reported.