Targeted therapy for gastric adenocarcinoma.

Gastric cancer (GC) is one of the leading causes of cancer death worldwide. Despite significant improvement in understanding disease biology and recent improvements in surgical outcome, radiation techniques, and chemotherapy, the 5-year survival rates remain divsmal. Several pathways related to cell proliferation, invasion, and metastasis have been identified and evaluated as candidates for targeted treatment but despite promising preclinical data, the majority of targeted agents failed to improve outcome in this disease. Recently, adding Trastuzumab-a HER-2 monoclonal antibody-to cisplatin-based chemotherapy in patients with HER-2 overexpressing gastric and gastroesophageal junction (GEJ) adenocarcinoma resulted in statistically significant improvement in response rate, progression-free survival, and overall survival in phase III trial. We have reviewed the different pathways relevant to gastric cancer development with focus on the recent advances in targeting these pathways in order to improve outcomes in this disease.