PURPOSE OF REVIEW: Gastric cancer is an uncommon cancer in the United States but is a very common cancer globally and is endemic in East Asia. It is a virulent cancer that presents with metastatic disease in about one half of United States patients. RECENT FINDINGS: In this review article, we discuss palliative chemotherapy options as well as validated preoperative, perioperative and postoperative strategies for locally advanced disease, which include chemotherapy and/or chemoradiation. SUMMARY: In the metastatic setting, there has been incremental improvement in cytotoxic chemotherapy combinations in the past 2 decades. Two targeted agents - trastuzumab and ramucirumab - are now approved. In the locally advanced setting, perioperative chemotherapy or postoperative chemotherapy or chemoradiation improves outcomes relative to surgery alone.
