[Therapy of advanced stomach carcinoma. Current study concepts]

Patients with gastric cancer have a poor prognosis. Only in early tumorstadium a tumor-free-resection is possible. Because curative surgery is often impossible or extremely difficult and the majority of patients undergoing curative resection relapse. To improve this situation adjuvant and neoadjuvant concepts necessary to check. Current adjuvant therapy regimes have a marginal importance. Only nodal positive patients (T3N2M0) may profit from an adjuvant therapy. Neoadjuvant concepts seem to be very effective. The activity is proving in two current studies. Several combination chemotherapy regimens have been developed with activity in locally advanced and metastatic disease. But only an overall survival in median of about 11 month could be reached and a standard protocol not exists. Therefore many studies are initiated. In the follow article three study concepts with new substances especially with Taxanes and with CPT-11 having a great potential to improve the prognosis of patients with advanced gastric cancer are explained.