Part of the book: Current Cancer Treatment
Part of the book: Cancer Treatment
Although the incidence of gastric cancer (GC) has declined steadily in recent years, GC remains a major cancer burden. Multimodal therapies have been developed and first-line chemotherapy for advanced GC patients, even they have good performance status, could provide only modest efficacy. Furthermore, treatment outcomes after failure of first-line chemotherapy remain poor. In order to provide a solution to this unmet clinical need, since the management of various types of cancer has progressed rapidly into the molecular era, biomarker-targeted therapy for GC has received enormous attention in recent years. This review focuses on the current treatment achievement of molecular targeting agents for GC, such as trastuzumab, pertuzumab, trastuzumab emtansine, lapatinib, cetuximab, panitumumab, nimotuzumab, mammalian target of rapamycin, bevacizumab, ramucirumab, sunitinib, sorafenib, apatinib, rilotumumab, and onartuzumab. However, problems are also emerged with regard to resistance and refractoriness. This chapter also focuses on the current obstacles concerning resistance and refractoriness, as well as provides discussions concerning future directions with regard to molecular categorization to predict response and toxicities leading to select patients most likely to benefit.
Part of the book: Gastric Cancer
Gastroesophageal reflux disease (GERD) encompasses a spectrum of disorders caused by a reflux of gastric contents into the esophagus or complications of gastroesophageal reflux. Although depending on the definition, the prevalence of GERD is higher in the West than in the East, and the prevalence has been slightly increasing, so that the clinicians, even though they are not gastroenterologists, must encounter GERD patients and treat them. However, the clinicians do feel difficulty in treating GERD patients, since prescription of acid neutralizing agents, such as proton pump inhibitors (PPIs), sometimes fail to resolve their complaints. This may be partly explained by the discrepancies between clinical complaint and endoscopic findings; some patients present endoscopic esophagitis while some do not, and be partly explained by the potentially wide spectrum of pathophysiological etiologies than has been thought. This chapter describes current knowledge on heterogeneous mechanisms of GERD development. Clarifying the mechanisms of GERD on the individual basis may realize conceptual shift from uniform prescription of acid neutralizing agents to establishment of patient-oriented therapies.
Part of the book: Gastroesophageal Reflux Disease