Current state of chemotherapy and immunotherapy regimens in gastric cancer

Despite improved understanding of the molecular characterization of gastric cancer and advances in drug development, the utilization of effective systemic therapies remains an ongoing challenge. However, the therapeutic armamentarium available to clinicians continues to expand. These agents have improved survival for patients with gastric cancer over the last decade. Chemotherapy continues to represent the mainstay of systemic treatment. More recently, the discovery of targeted and immunotherapies herald the opportunity to provide durable and potentially curative antitumor responses without traditional toxicities associated with cytotoxic agents. This chapter specifically outlines contemporary management of locally advanced and metastatic gastric adenocarcinoma using systemic therapies. We highlight current standards of care internationally and outline future directions including the landscape of clinical trials.