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Two steps forward and one step back

Perioperative chemotherapy is the standard of care for localized gastric cancer (GC). In 2018, additional postoperative radiotherapy was found to be ineffective; although, docetaxel was found to be superior to epirubicin in perioperative three-drug chemotherapy regimens. Validated biomarkers are needed for benefit from immunotherapy in advanced-stage GC. Metachronous GC can be prevented by Helicobacter pylori eradication.

Key advances

  • Docetaxel should replace epirubicin in three-drug perioperative chemotherapy regimens for patients with localized gastric cancer4.

  • Immune-checkpoint inhibition has limited efficacy in patients with advanced-stage gastric cancer; further research exploring biomarkers to identify patient groups who are most likely to benefit is mandatory7.

  • Eradication of Helicobacter pylori infection reduces the risk of metachronous gastric cancer in patients with resected early stage gastric cancer and in those with high-grade adenoma10.

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Correspondence to Florian Lordick.

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Competing interests

F.L. has received honoraria for consulting or advisory roles, membership of a data safety board or lectures from Amgen, Astellas, AstraZeneca, Biontech, Bristol-Myers Squibb, Eli Lilly, Elsevier, Infomedica, Merck, MSD, Roche and Servier, and has received research support (institutional) from BMS. E.C.S. has received honoraria for consulting or advisory roles from BMS, Celgene, Five Prime Therapeutics, Gritstone Oncology and Servier.

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Lordick, F., Smyth, E.C. Two steps forward and one step back. Nat Rev Clin Oncol 16, 69–70 (2019).

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