Published online Jan 16, 2015. doi: 10.12998/wjcc.v3.i1.42
Peer-review started: August 6, 2014
First decision: September 16, 2014
Revised: October 9, 2014
Accepted: November 17, 2014
Article in press: December 23, 2014
Published online: January 16, 2015
Recent advances in molecular targeted therapies, including targeting human epidermal growth factor receptor 2 (HER2), had a major forward step in the therapy for gastric cancer patients. Application of HER2-targeted therapies, in particular trastuzumab in combination with chemotherapy in metastatic HER2-positive gastric cancers, resulted in improvements in response rates, time to progression and overall survival. Nevertheless, as with breast cancer, many patients with gastric cancer develop resistance to trastuzumab. Several promising therapies are currently being developed in combination with chemotherapy to increase the efficacy and overcome the cancer-resistance. Here we review the current overview of clinical application of agents targeting HER2 in gastric cancer. We also discuss the ongoing trials supporting the use of HER2-targeted agents combined with cytotoxic agents or other monoclonal antibodies.
Core tip: This review summarizes the development of diagnostic and therapeutic approach for the patients with human epidermal growth factor receptor 2 (HER2)-overexpressed/amplified gastric cancer. The biology of HER2-dependent signalling is also described. The ToGA trial highlighted the importance of accurate HER2 testing to guide treatment choice of gastric cancer. Future strategies beyond the ToGA trial to address EFGR family, including HER2 pathway are discussed according to current ongoing clinical trials, as well as experimental studies.