3a92d4ea41523514db74a2ea9b4baa97 pmc_8945913.pdf db07b09b74e86feda83ce2059080f740225e0e08 pmc_8945913.pdf f645969a898c9f95d63e1fef3a4b4ea30ef582b8bc7449b8a74fb28dd25bd24b pmc_8945913.pdf Title: Chemorefractory Gastric Cancer: The Evolving Terrain of Third-Line Therapy and Beyond Subject: Gastric and gastro-oesophageal junction cancer (GC) represent a global healthcare problem being the fifth most common tumour type and the fourth cause of cancer mortality. Extremely poor median survival of approximately 10 months is normally reported within advanced GC patients, mainly secondary to two factors, i.e., the fragility of these patients and the aggressiveness of this disease. In this context, the correct treatment of GC patients requires not only a multidisciplinary team with special attention to palliative and nutritional care but also a close follow-up with regular monitoring of disease symptoms and tumour evaluation. Sequential treatment lines with few toxic adverse events have emerged as the best therapeutic approach, and a third line of therapy could further improve survival and quality of life of GC patients. Chemotherapy, immunotherapy, and targeted agents -when indicated- constitute the treatment armamentarium of these patients. In this review, we discuss treatment options in the refractory setting as well as novel approaches to overcome the poor prognosis of GC. Keywords: gastric cancer; gastro-oesophageal junction cancer; third line of treatment; sequential treatment approach; molecular approach Author: Maria Alsina, Josep Tabernero and Marc Diez Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Mar 10 10:24:11 2022 CET ModDate: Thu Mar 10 10:25:41 2022 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 535932 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JFWIOK+VnURWPalladioL Type 1 Custom yes yes no 10 0 SWRKIA+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 JTRGEY+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 YFLESO+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 32 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 36 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 40 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 53 0 JOGPBC+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 89 0 JOGPCC+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 95 0 JOGPED+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 101 0 JOGPEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 107 0 JOGPEF+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 110 0 JOGPEG+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 113 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 126 0 PDTLUH+CMSY10 Type 1 Builtin yes yes no 130 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2022-06-02 02:43:09 CEST RepresentationInformation: pmc_8945913.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-04-26 18:00:27 CEST Size: 535932 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 350 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4923ab24 Item: Title: Initial Approach Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Close Follow-Up Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Clinical Trials in the Refractory Setting Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Children: Item: Title: Chemotherapy Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Immunotherapy Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Target Therapies Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Novel Treatment Approaches Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Info: Title: Chemorefractory Gastric Cancer: The Evolving Terrain of Third-Line Therapy and Beyond Author: Maria Alsina, Josep Tabernero and Marc Diez Subject: Gastric and gastro-oesophageal junction cancer (GC) represent a global healthcare problem being the fifth most common tumour type and the fourth cause of cancer mortality. Extremely poor median survival of approximately 10 months is normally reported within advanced GC patients, mainly secondary to two factors, i.e., the fragility of these patients and the aggressiveness of this disease. In this context, the correct treatment of GC patients requires not only a multidisciplinary team with special attention to palliative and nutritional care but also a close follow-up with regular monitoring of disease symptoms and tumour evaluation. Sequential treatment lines with few toxic adverse events have emerged as the best therapeutic approach, and a third line of therapy could further improve survival and quality of life of GC patients. Chemotherapy, immunotherapy, and targeted agents -when indicated- constitute the treatment armamentarium of these patients. In this review, we discuss treatment options in the refractory setting as well as novel approaches to overcome the poor prognosis of GC. 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