Drug therapy for respectable stomach cancer

Gastric cancer remains one of the leading causes of death from malignant tumors worldwide, despite a decrease in overall incidence in recent decades [1]. The prognosis for patients with localized gastric cancer remains extremely unfavorable, and the course of the disease is aggressive. Traditionally, the main method of treatment of locally advanced gastric cancer was surgery. However, even after radical resection (R0) the five-year survival rate rarely exceeded 30%, and recurrences occurred in 50-90% of patients [2]. The development of multimodal treatment approaches including neoadjuvant, perioperative and adjuvant chemotherapy was aimed at improving radicalization and survival. Since the 1970s, there have been marked improvements in 5-year survival rates, increasing from 15% in 1975 to 29% in 2009. This article reviews the historical development of drug therapy for locally advanced gastric cancer, current standards, and future prospects for perioperative treatment. Despite significant progress in this area, including the addition of targeted agents and immunotherapy to neoadjuvant therapy, therapeutic outcomes have steadily improved, but unresolved issues remain, including the treatment of the diffuse subtype of gastric cancer.