Future perspectives for the development of chemotherapy for advanced gastric cancer: Japanese and global status.

In Japan, gastric cancer is the second leading cause of cancer-related mortality after lung cancer. Many randomized trials of various chemotherapeutic regimens have been conducted, contributing to improved outcomes in patients with advanced gastric cancer (AGC). The standard regimen for AGC is a combination of S-1 and cisplatin in Japan. Recently, new drug development has focused on molecular target agents, and personalized therapy for AGC has just begun. In patients with human epidermal growth factor receptor 2-positive AGC, trastuzumab in combination with chemotherapy improves survival. Furthermore, abundant information about the heterogeneity and biological backgrounds of AGC patients has been compiled. New strategies for the development of personalized therapy should be studied in the future.