[Adjuvant Chemotherapy for Gastric Cancer]

Postoperative S-1 monotherapy significantly improved survival in patients with Stage II/III gastric cancer who underwent a curative resection in the ACTS-GC study. Based on this result, Japanese gastric cancer treatment guidelines recommend adjuvant S-1 treatment for 1 year for Stage II/III patients who underwent a curative resection as a standard treatment. However, the subgroup analysis of the ACTS-GC study revealed that the efficacy of S-1 therapy was a bit weak in Stage III patients. Therefore, more intensive treatments, such as adjuvant doublet and neoadjuvant chemotherapy, are now under development. The efficacy of adjuvant XELOX has been reported in Korea; however, it is unclear whether adjuvant doublet therapy demonstrates stronger activity than monotherapy in an adjuvant setting. On the other hand, neoadjuvant plus adjuvant( peri-operative)chemotherapy and chemoradiotherapy are considered to be the standard treatments in Western countries. The current status and future prospects for adjuvant chemotherapy for gastric cancer are reviewed herein.