Page 237 - Read Online

Harada et al. J Cancer Metastasis Treat 2018;4:18 Journal of Cancer
DOI: 10.20517/2394-4722.2017.74 Metastasis and Treatment

Review Open Access

Recent trend in gastric cancer treatment in the USA

Kazuto Harada , Hideo Baba , Jaffer A. Ajani 1
2
1,2
1 Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
2 Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto 860-
8556, Japan.
Correspondence to: Dr. Jaffer A. Ajani, Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson
Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA. E-mail: jajani@mdanderson.org

How to cite this article: Harada K, Baba H, Ajani JA. Recent trend in gastric cancer treatment in the USA. J Cancer Metastasis Treat
2018;4:18. http://dx.doi.org/10.20517/2394-4722.2017.74

Received: 21 Dec 2017 First Decision: 8 Jan 2018 Revised: 27 Mar 2018 Accepted: 4 Apr 2018 Published: 26 Apr 2018
Science Editor: Masayuki Watanabe Copy Editor: Jun-Yao Li Production Editor: Cai-Hong Wang

Abstract
Gastric adenocarcinoma (GAC) is estimated as the fifteenth most common cancer in the USA. Incidence rate has been
gradually decreasing, but prognosis remains dismal. For patients with locally advanced GAC (stage > T1B and < T4B),
multimodality therapies, such as surgery, chemotherapy, and radiation therapy, are needed. Perioperative chemotherapy
or postoperative chemoradiation/chemotherapy is recommended. For metastatic GAC patients, combination of two
cytotoxics (platinum compound and fluoropyrimidine) has become a common place in the USA, and when HER2 is
positive, trastuzumab is added. When GAC progresses after the first line therapy, additional biomarkers (microsatellite
instability and programmed death ligand 1) should be tested so that checkpoint inhibitors can be used. Overall, the
options for advanced GAC patients are limited and more research is needed.

Keywords: Gastric adenocarcinoma, chemotherapy, chemoradiation, preoperative treatment

EPIDEMIOLOGY IN THE USA
Gastric adenocarcinoma (GAC) is estimated as the fifteenth most common cancer in the USA; 28,000 new
cases are estimated in a year, which is 1.7% of all new cancer cases . Incidence rate has been gradually
[1]
decreasing; number of new cases per 100,000 people is 11.7 in 1975, 9.3 in 1990, 8.1 in 2000, and 6.6 in 2014 .
[1]
In total 10,960 deaths are estimated in a year, which is 1.8% of all cancer death . The 5-year survival rate of
[1]
GAC in the USA is 30.6%; 53% GAC are localized at diagnosis, and the 5-year survival rate of localized GAC
(no lymph node involvement) and regional GAC (regional lymph node involvement) is 67.2% and 30.7%,
respectively ; 35% GAC are diagnosed as metastatic disease and have a poor outcome .
[1]
[1]
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.jcmtjournal.com