Advances and Challenges in Gastric Cancer Management: Chemotherapy, Radiation, and Targeted Therapy

Gastric cancer continues to rank as one of the most prevalent and deadly cancers globally. There is an overall five-year survival rate of less than 40% with worse outcomes in advanced stages. Gastric Cancer (GC) has poor prognosis indicators due to late diagnosis and therapy resistance. Standard treatment for gastric cancers includes surgery with systemic or localized therapies. Chemotherapy, which is often administered in neoadjuvant and adjuvant settings, employs combinations of drugs to shrink tumors, decrease the risk of recurrence, and improve survival. These therapies are successful but have some challenges, like toxicity and resistance remaining huge. Radiation therapy can be delivered as three dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiation therapy (IMRT), as a means to offer enhanced local tumor control. When combined with chemotherapy, radiotherapy has shown greater survival benefits, like in clinical trials such as INT-0116. Targeted therapies like trastuzumab for HER2-positive disease and claudin 18.2 antibodies represent a change towards precision by offering improved selectivity, but this is restricted to groups with specific biomarkers. This paper reviews current treatments, chemotherapy, radiation, and targeted therapies, while highlighting their benefits, weaknesses, and the growth of individualized treatment in improving outcomes for patients