Chemotherapy for advanced gastric cancer: review of global and Japanese status.

Gastric cancer is the second most common cause of cancer death in the world. In Japan, it is the most commonly diagnosed cancer and the second leading cause of cancer death. Standard treatment for advanced gastric cancer has not been established and prognosis remains poor worldwide. Numerous phase II studies have demonstrated promising results in overall response rate for new agents such as docetaxel, irinotecan, oxaliplatin, capecitabine, and S-1; some of these new agents may have improved toxicity profiles. Dozens of hase III studies comparing chemotherapy regimens have been conducted globally, several of which are ongoing in Japan. Results will be available in the near future. However, potential gains seem limited with the new regimens: a less than 1- to 2-month improvement in survival and a 10% or less improvement in response rate. This article reviews the history of, and recent progress in, chemotherapy for advanced gastric cancer globally, with a detailed look at investigations in Japan.