Biondi A, Lirosi MC, D’Ugo D, Fico V, Ricci R, Santullo F, Rizzuto A, Cananzi FC, Persiani R. Neo-adjuvant chemo(radio)therapy in gastric cancer: Current status and future perspectives. World J Gastrointest Oncol 2015; 7(12): 389-400 [PMID: 26690252 DOI: 10.4251/wjgo.v7.i12.389]
Corresponding Author of This Article
Alberto Biondi, MD, General Surgery Unit, Department of Surgery, “A. Gemelli” University Hospital Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy. biondi.alberto@tiscali.it
Research Domain of This Article
Oncology
Article-Type of This Article
Topic Highlight
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Dec 15, 2015; 7(12): 389-400 Published online Dec 15, 2015. doi: 10.4251/wjgo.v7.i12.389
Neo-adjuvant chemo(radio)therapy in gastric cancer: Current status and future perspectives
Alberto Biondi, Maria C Lirosi, Domenico D’Ugo, Valeria Fico, Riccardo Ricci, Francesco Santullo, Antonia Rizzuto, Ferdinando CM Cananzi, Roberto Persiani
Alberto Biondi, Maria C Lirosi, Domenico D’Ugo, Valeria Fico, Francesco Santullo, Roberto Persiani, General Surgery Unit, Department of Surgery, “A. Gemelli” University Hospital Catholic University of Rome, 00168 Rome, Italy
Riccardo Ricci, Department of Pathology, “A. Gemelli” University Hospital Catholic University of Rome, 00168 Rome, Italy
Antonia Rizzuto, Department of Medical and Surgical Sciences, Universita degli studi Magna Graecia di Catanzaro, Viale Europa - Localitá Germaneto, 88100 Catanzaro, Italy
Ferdinando CM Cananzi, Surgical Oncology Unit, Humanitas Clinical and Research Center, 20089 Rozzano, Italy
Author contributions: Biondi A, Lirosi MC, D’Ugo D, Ricci R, Fico V, Santullo F, Rizzuto A, Cananzi FCM, Persiani R equally participated in the conception, design, and drafting of this article; all the authors revised the article critically for important intellectual content and gave final approval of the version to be published.
Conflict-of-interest statement: All the authors do not have any conflict of interest as it pertains to the content of this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alberto Biondi, MD, General Surgery Unit, Department of Surgery, “A. Gemelli” University Hospital Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy. biondi.alberto@tiscali.it
Telephone: +39-6-30154511 Fax: +39-6-3051162
Received: March 18, 2015 Peer-review started: March 19, 2015 First decision: April 23, 2015 Revised: May 16, 2015 Accepted: October 12, 2015 Article in press: October 15, 2015 Published online: December 15, 2015 Processing time: 229 Days and 20 Hours
Abstract
In the last 20 years, several clinical trials on neoadjuvant chemotherapy and chemo-radiotherapy as a therapeutic approach for locally advanced gastric cancer have been performed. Even if more data are necessary to define the roles of these approaches, the results of preoperative treatments in the combined treatment of gastric adenocarcinoma are encouraging because this approach has led to a higher rate of curative surgical resection. Owing to the results of most recent randomized phase III studies, neoadjuvant chemotherapy for locally advanced resectable gastric cancer has satisfied the determination of level I evidence. Remaining concerns pertain to the choice of the optimal therapy regimen, strict patient selection by accurate pre-operative staging, standardization of surgical procedures, and valid criteria for response evaluation. New well-designed trials will be necessary to find the best therapeutic approach in pre-operative settings and the best way to combine old-generation chemotherapeutic drugs with new-generation molecules.
Core tip: Owing to the results of the most recent randomized phase III studies, neoadjuvant chemotherapy for locally advanced resectable gastric cancer has satisfied the determination of Level I evidence. Remaining concerns pertain to the choice of the optimal therapy regimen, strict patient selection by accurate pre-operative staging, standardization of surgical procedures, and reliable criteria for response evaluation. New well-designed trials will be necessary to identify the best treatment plan in pre-operative settings and to understand how to combine the conventional chemotherapeutic drugs with new-generation molecules.
