Due to its high incidence and poor prognosis, gastric cancer is an important health problem worldwide. The only possible curative treatment is to remove the primary tumor at an early stage of the disease. However, at diagnosis, most patients have unresectable or metastatic disease. Relapse in patients after primary surgery is frequent. In these patients, the aim of treatment is to extend the duration of survival and to improve quality of life and this accomplished by systemic therapies. Regimens containing fluoropyrimidine and platinum agents, in combination with trastuzumab in patients with overexpression of human epidermal growth factor receptor 2 (HER2), are recommended as the first-line treatment. Unfortunately, all patients develop progressive disease, but at least half of them are eligible for further treatment. This article presents current possibilities and near-future developments of chemotherapy and molecular targeted-therapy in patients with advanced gastric cancer after failure of prior regimens containing fluoropyrimidine and platinum.
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