[Advances in secondary chemotherapy for gastric cancer]

Although both the response rate and survival time of patients with metastatic or recurrent gastric cancer have improved through the development of new anti-cancer agents, it is still difficult to achieve a complete response(CR)of a tumor. Compared to the best supportive care alone, second-line chemotherapy can prolong survival after the failure of first-line therapy in patients who otherwise are in good health. In the WJOG4407 trial, which compared irinotecan and paclitaxel as secondary chemotherapies, there was no difference in response rate or survival time. A large proportion of these patients could undergo third-line chemotherapy, and paclitaxel is currently used as a control in many secondary chemotherapy trials. The molecularly targeted agents ramucirumab and apatinib have been shown to have high efficacy in phase III trials. Ramucirumab will be approved for medical insurance reimbursement next year in Japan, and its combination with paclitaxel is considered the standard treatment for this malignancy.