Advancements and challenges in treating advanced gastric cancer in the West

Table 4 Targeted treatment trials

Trial name	Country	Status	Years	Target	Groups	Chemotherapy regimens	Outcome
EXPAND	Multiple	Complete	2008-2010	EGFR	Standard chemo	Capecitabine, cisplatin	No difference in PFS
					Standard chemo with cetuximab	Capecitabine, cisplatin, cetuximab
REAL3	Multiple	Complete	2008-2011	EGFR	Standard chemo	Epirubicin, oxaliplatin, capecitabine	No difference in OS
					Standard chemo with panitumumab	Epirubicin, oxaliplatin, capecitabine, panitumumab
AVAGAST	Multiple	Complete	2007-2008	VEGFR	Standard chemo	Capecitabine, cisplatin	Improved PFS in the bevacizumab group (median survival 6.7 mo vs 5.3 mo)
					Standard chemo with	Capecitabine, cisplatin,
					bevacizumab	bevacizumab
REGARD	Multiple	Complete	2009-2012	VEGFR	Best supportive care	-	Improved OS in ramucirumab group (median survival 5.2 mo vs 3.8 mo)
					Best supportive care	Ramucirumab
					with ramucirumab
ToGA Trial	Multiple	Complete	2005-2008	HER2	Standard chemo	Cisplatin with capecitabine or 5-FU	Improved OS in the trastuzumab group (median survival 13.8 mo vs 11.1 mo)
					Standard chemo with trastuzumab	Cisplatin, capecitabine or 5-FU, trastuzumab
KEYNOTE-012	Multiple	Complete	2013-2014	PD-L1	Pembrolizumab	Pembrolizumab	Median OS of 11.4 mo
GASTRICHIP (NCT01882933)	Multiple	Ongoing	-	HIPEC	Curative gastrectomy with D1-D2 lymph node dissection	-	-
					Curative gastrectomy with D1-D2 lymph node dissection with HIPEC	IP Oxaliplatin with IV 5-FU and leucovorin

EGFR: Endothelial growth factor receptor; chemo: Chemotherapy; PFS: Progression-free survival; OS: Overall survival; AVAGAST: Avastin in Gastric Cancer; VEGFR: Vascular endothelial growth factor receptor; ToGA: Trastuzumab for Gastric Cancer; HER2: Human epidermal growth factor receptor 2; 5-FU: 5-fluorouracil; PD-L1: Programmed death-ligand 1; HIPEC: Hyperthermic intraperitoneal chemotherapy; IP: Intraperitoneal; IV: Intravascular.