[Locally advanced or metastatic gastric cancer--new therapeutic solutions]

Gastric cancer represents a major health problem worldwide. It is often diagnosed at an advanced stage, because screening, which would help an early detection is performed only in Japan. Gastric cancer rates may be decreased by reducing smoking and alcohol consumption and by increasing the number of fresh fruits and vegetables eaten. Eradication of Helicobacter pylori may also decrease gastric cancer incidence. Seventy-five percent of the patients are diagnosed in unresectable stage. They represent a challenge for clinicians as they have to choose between a strictly supportive approach or to expose patients to the side-effects of a potentially ineffective treatment. The treatment of advanced gastric cancer is essentially palliative. Therapy's main aim in this common group of patients with unresectable or metastatic disease is to achieve good symptomatic control, to improve quality of life, to avoid tumor progression and to prolong survival.