Neoadjuvant chemotherapy and ongoing-trials

Abstract

AIM: The history of preoperative therapy for gastric carcinoma was outlined here to demonstrate its value in terms of safety and efficacy.

MATERIAL OF STUDY: The data collected in this review were obtained from studies found in PubMed using the search terms “preoperative chemotherapy”, “preoperative radiotherapy”, “preoperative chemoradiotherapy”, “neoadjuvant treatment”, and “gastric cancer”. Only papers published in English language between January 1970 and January 2010 were selected.

RESULTS: Studies conducted over the last twenty years have progressed from the first “pioneering” chemotherapies for patients with non-resectable disease (“induction” therapy) to the most recent phase III trials of a “neoadjuvant” therapy for resectable gastric neoplasms.

DISCUSSION: Several clinical trials of pre-operative chemotherapy in the management of gastric cancer have been attempted. Despite needing further data regarding the definitive role of neoadjuvant therapy, the results of preoperative chemotherapy in the multimodal treatment of gastric adenocarcinoma are encouraging since the treatment increase the likelihood that a truly “curative” (R0) delayed surgical procedure can be achieved. Owing to the results of last randomized phase III studies, neoadjuvant chemotherapy for locally advanced resectable gastric cancer has become a level I evidence.