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The Sidney Kimmel Comprehensive Cancer Center

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Chemotherapy and Targeted Drug Therapy for Stomach Cancer

Chemotherapy is the use of medications to destroy cancer cells. It may be recommended as part of a treatment plan for certain types of stomach cancer. Targeted drug therapy is a type of chemotherapy in which the medication works on specific proteins present in cancer cells or specific aspects of certain types of tumors.

The multidisciplinary team at the Johns Hopkins Center for Stomach Cancer Care will determine which combination of treatments is best for each individual patient.

Chemotherapy is given in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Each cycle typically lasts for a few weeks.

Types of Chemotherapy Used to Treat Stomach Cancer

Depending on the type of stomach (gastric) cancer, stage and the patient’s general health and prognosis, doctors orally or intravenously administer one or a combination of chemotherapy drugs at different points during treatment.

  • Neoadjuvant chemotherapy (chemotherapy before surgery): Studies have shown that patients with locally advanced stomach cancer have improved survival if chemotherapy is given prior to surgery. This treatment may also be given in conjunction with radiation therapy. Patients receiving chemotherapy and radiation together may require nutritional support due to significant weight loss and nausea inhibiting adequate nourishment.
  • Adjuvant chemotherapy (chemotherapy after surgery): Patients diagnosed with more advanced stomach cancer are often given postsurgical chemotherapy as part of their overall treatment plan.

Chemotherapy is also given to patients with advanced stomach cancer that is not amenable to surgery.

Targeted Drug Therapy for Treating Stomach Cancer

Targeted drugs exploit the unique genetic, biological and molecular structures of stomach cancer cells.

Trastuzumab is a drug that targets a certain protein called HER2, which is found to varying degrees in stomach cancer cells. When given in conjunction with standard chemotherapy, trastuzumab can help some patients with advanced stomach cancer live longer than with chemotherapy alone.

Other types of targeted drug therapies work by preventing the cancer from forming new blood vessels. This stunts the tumor’s growth and prevents it from spreading. These agents may be given alone or with chemotherapy to patients with advanced stomach cancer.

Immunotherapy for Stomach Cancer

Immunotherapy is a new class of drugs that work to activate your body’s immune system to fight the cancer. Because immunotherapy works in a different way than traditional chemotherapy, it may be effective when chemotherapy is not and is often much better tolerated than chemotherapy.

One such immunotherapy drug is pembrolizumab (Keytruda), which has been shown to be effective in certain types of advanced stomach cancer. Additional tests may be done on an individual’s tumor to determine whether it is likely to respond to pembrolizumab.