[Innovations in the Current Guideline on Gastric Carcinoma and Outlook for the Future]

The third version of the national S3 guideline for gastric cancer is currently being finalised and will be published in the near future. Therefore, this review article primarily discusses the aspects of the current 2019 version and provides an outlook on the innovations in the upcoming version. Emphasis will be placed on the transfer of care to centres with appropriate expertise. Overall, previous revisions of the guideline have placed an increased focus on the genetic aspects of the disease and have specified corresponding risk groups for the occurrence of this neoplasia (including the presence of a CDH1 mutation or HNPCC carriers). In addition, more "borderline" cases for surgery, such as patients with oligometastasis or peritoneal carcinomatosis, have been included in the guidelines. However, for the time being, these patient groups should only be treated in trials. Finally, the guideline discusses the increasing use of immunotherapy in current and future treatment regimens, in addition to the current chemotherapeutic standard of care analogous to the FLOT regimen. New targeted therapeutic approaches such as monoclonal antibodies against claudin 18.2 will complement the treatment of gastric cancer and will certainly be included in the next version of the guideline.