Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology

Jaffer A. Ajani(The University of Texas MD Anderson Cancer Center), Thomas A. D’Amico(Cancer Institute (WIA)), David J. Bentrem(Robert H. Lurie Comprehensive Cancer Center of Northwestern University), Joseph Chao(City Of Hope National Medical Center), David T. Cooke(UC Davis Comprehensive Cancer Center), Carlos U. Corvera(UCSF Helen Diller Family Comprehensive Cancer Center), Prajnan Das(The University of Texas MD Anderson Cancer Center), Peter C. Enzinger(Massachusetts General Hospital), Thomas Enzler(University of Michigan), Paul T. Fanta(University of California San Diego), Farhood Farjah(Cape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South Africa), Hans Gerdes(Memorial Sloan Kettering Cancer Center), Michael K. Gibson(Breast Cancer Research Foundation), Steven N. Hochwald, Wayne L. Hofstetter(The University of Texas MD Anderson Cancer Center), David H. Ilson(Memorial Sloan Kettering Cancer Center), Rajesh N. Keswani(Robert H. Lurie Comprehensive Cancer Center of Northwestern University), Sunnie S. Y. Kim(University of Colorado Cancer Center), Lawrence Kleinberg(Sidney Kimmel Comprehensive Cancer Center), Samuel J. Klempner(Massachusetts General Hospital), Jill Lacy(Smilow Cancer Hospital), Quan P. Ly(Susan Thompson Buffett Foundation), Kristina A. Matkowskyj(University of Wisconsin Carbone Cancer Center), Michael J. McNamara(Cleveland Clinic), Mary F. Mulcahy(Robert H. Lurie Comprehensive Cancer Center of Northwestern University), Darryl Outlaw(University of Colorado Cancer Center), Haeseong Park(Barnes-Jewish Hospital), Kyle A. Perry(The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute), José M. Pimiento(Moffitt Cancer Center), George A. Poultsides(Cancer Institute (WIA)), Scott I. Reznik(Southwestern Medical Center), Robert E. Roses(University of Pennsylvania), Vivian E. Strong(Memorial Sloan Kettering Cancer Center), Stacey Su(Fox Chase Cancer Center), Hanlin L. Wang(University of Colorado Cancer Center), Georgia L. Wiesner(Breast Cancer Research Foundation), Christopher G. Willett(Cancer Institute (WIA)), Danny Yakoub(St. Jude Children's Research Hospital), Harry H. Yoon, Nicole R. McMillian(National Comprehensive Cancer Network), Lenora A. Pluchino(National Comprehensive Cancer Network)
Journal of the National Comprehensive Cancer Network
February 1, 2022
10.6004/jnccn.2022.0008
Cited by 1,682Open Access
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Abstract

Gastric cancer is the third leading cause of cancer-related deaths worldwide. Over 95% of gastric cancers are adenocarcinomas, which are typically classified based on anatomic location and histologic type. Gastric cancer generally carries a poor prognosis because it is often diagnosed at an advanced stage. Systemic therapy can provide palliation, improved survival, and enhanced quality of life in patients with locally advanced or metastatic disease. The implementation of biomarker testing, especially analysis of HER2 status, microsatellite instability (MSI) status, and the expression of programmed death-ligand 1 (PD-L1), has had a significant impact on clinical practice and patient care. Targeted therapies including trastuzumab, nivolumab, and pembrolizumab have produced encouraging results in clinical trials for the treatment of patients with locally advanced or metastatic disease. Palliative management, which may include systemic therapy, chemoradiation, and/or best supportive care, is recommended for all patients with unresectable or metastatic cancer. Multidisciplinary team management is essential for all patients with localized gastric cancer. This selection from the NCCN Guidelines for Gastric Cancer focuses on the management of unresectable locally advanced, recurrent, or metastatic disease.

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