Treatment of locally advanced and metastatic gastric cancer

The incidence of gastric cancer is decreasing. However, there is a shift of primary tumor localisation from the stomach to the oesophago-gastric junction. Palliative treatment with combination chemotherapy is effective with remission rates of around 35%. The best scheme which was thouroughly evaluated and compaired with other therapy protocols is FAMTX. In the neoadjuvant setting good results have been achieved with FAMTX, too. The efficacy of adjuvant treatment is still not solved. for the future, incorporation of new cytostatic drugs like irinotecan, topotecan, or tomudex in existing protocols seems promising. The same holds true for cytokines.