Gastric cancer is a common type of malignant tumors, but its clinical prognosis remains unsatisfactory. Up to 2020, a growing number of high-quality clinical researches has provided reliable evidence for clinical practice. Evidences from surgery, perioperative treatment and immunotherapy, such as changes in surgical methods, improvement of perioperative chemotherapy and combination of immune and chemotherapy strategy, provided the possibility to improve the clinical efficacy of gastric cancer. In our clinical practice, gastrointestinal surgeons need to integrate the current research progression and develop individualized strategy for different patients, which is expected to further improve the prognosis and quality of life for patients with gastric cancer.
Biomedical Research/trends* ; Combined Modality Therapy ; Gastrectomy ; Humans ; Prognosis ; Quality of Life ; Stomach Neoplasms/therapy*

Local advanced gastric cancer (LAGC) accounts for a large proportion of annual newly diagnosed gastric cancer patients in China. There is a general consensus for D2 radical gastrectomy followed by postoperative adjuvant chemotherapy for LAGC patients, and this therapeutic strategy has been confirmed by a series of clinical trials to obviously improve the patients' prognosis; however, the recurrence rate is still high (about 50%-80% in advanced stage), which makes it difficult to further improve the long-term survival. Perioperative therapy, especially whether preoperative neoadjuvant therapy (NAT) can improve the efficacy of patients with LAGC, has been paid more and more attention. NAT is mainly defined as a preoperative chemotherapy or chemoradiotherapy, aiming at increasing curative resection rate by downstaging tumor, eliminating micrometastases, and autologously testing of anti-cancer drug sensitivity etc. However, there are still some controversy whether LAGC patients could gain survival benefit from NAT and also lack of general consensus for this issue. In this paper, the author reviews and analyzes the current situation of perioperative therapies for LAGC patients, especially emphasize the results of neoadjuvant chemotherapy or chemoradiotherapy reported by various high-level clinical studies. The preliminary effect of perioperative chemotherapy combined with molecular targeted or immunotherapy has also aroused great interest and attention. While we continue to carry out NAT and look forward to more new high-level evidence trials on NAT, we must emphasize again that R0 gastrectomy remains the most important therapeutic modality for the patients with LAGC.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Gastrectomy/methods* ; Humans ; Lymph Node Excision ; Neoadjuvant Therapy ; Neoplasm Staging ; Perioperative Care/trends* ; Stomach Neoplasms/therapy*

Strategies in comprehensive therapy for gastrointestinal (GI) cancer have been optimized in the last decades to improve patients' outcomes. However, treatment options remain limited for late-stage or refractory diseases. The efficacy of immune checkpoint inhibitors (ICIs) for treatment of refractory GI cancer has been confirmed by randomized clinical trials. In 2017, pembrolizumab was approved by the US Food and Drug Administration as the first agent for treatment of metastatic solid tumors with mismatch repair deficiency, especially for colorectal cancer. Given the different mechanisms, oncologists have focused on determining whether ICIs-based combination strategies could achieve higher efficacy than conventional therapy alone in late-stage or even front-line treatment of GI cancer. This review discusses the current status of combining immune checkpoint inhibitors with molecular targeted therapy, chemotherapy, or radiotherapy in GI cancer in terms of mechanisms, safety, and efficacy to provide basis for future research.
Combined Modality Therapy ; methods ; Gastrointestinal Neoplasms ; immunology ; therapy ; Humans ; Immunotherapy ; methods ; trends ; Randomized Controlled Trials as Topic

Multiple therapeutic modalities are available for hepatocellular carcinoma (HCC) treatment. We aimed to evaluate the trends for HCC treatment in Korea. Recent trends and patterns in treatment modalities were assessed in HCC patients who first registered for the Health Insurance Review Assessment Service between 2008 and 2012. From 2009 to 2012, 57,690 patients were diagnosed with HCC. Transcatheter arterial chemoembolization (TACE) was the most common treatment modality for initial treatment. Curative treatment modalities like hepatic resection, liver transplantation, and local ablation therapy increased gradually. The 3 most common treatment modalities (hepatic resection, local ablation therapy, TACE) used after initial treatment in 2009 were studied. Following initial hepatic resection, 44.5% of patients required re-treatment. TACE was the most common modality (in 48.3% of cases), while 15.0% of patients received local ablation therapy. After local ablation therapy, 55.4% of patients were re-treated, wherein 45.0% of patients received TACE and 31.5% received local ablation therapy. Following initial TACE, 73.9% patients were re-treated, most commonly with TACE (57.7%) followed by local ablation therapy (12.8%). While there were no significant differences between the initial and re-treatment modalities, various multiple treatments followed the initial treatment. The treatment modalities were interchangeable.
Aged ; Carcinoma, Hepatocellular/epidemiology/pathology/*therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy/trends ; Cross-Sectional Studies ; Databases, Factual ; Female ; Humans ; Insurance Claim Review ; Liver Neoplasms/epidemiology/pathology/*therapy ; Liver Transplantation ; Male ; Middle Aged ; Niacinamide/administration & dosage/analogs & derivatives ; Phenylurea Compounds/administration & dosage ; Prevalence ; Protein Kinase Inhibitors/administration & dosage ; Republic of Korea/epidemiology

In 2015, fourteen topics were selected as major research advances in gynecologic oncology. For ovarian cancer, high-level evidence for annual screening with multimodal strategy which could reduce ovarian cancer deaths was reported. The best preventive strategies with current status of evidence level were also summarized. Final report of chemotherapy or upfront surgery (CHORUS) trial of neoadjuvant chemotherapy in advanced stage ovarian cancer and individualized therapy based on gene characteristics followed. There was no sign of abating in great interest in immunotherapy as well as targeted therapies in various gynecologic cancers. The fifth Ovarian Cancer Consensus Conference which was held in November 7–9 in Tokyo was briefly introduced. For cervical cancer, update of human papillomavirus vaccines regarding two-dose regimen, 9-valent vaccine, and therapeutic vaccine was reviewed. For corpus cancer, the safety concern of power morcellation in presumed fibroids was explored again with regard to age and prevalence of corpus malignancy. Hormone therapy and endometrial cancer risk, trabectedin as an option for leiomyosarcoma, endometrial cancer and Lynch syndrome, and the radiation therapy guidelines were also discussed. In addition, adjuvant therapy in vulvar cancer and the updated of targeted therapy in gynecologic cancer were addressed. For breast cancer, palbociclib in hormone-receptor-positive advanced disease, oncotype DX Recurrence Score in low-risk patients, regional nodal irradiation to internal mammary, supraclavicular, and axillary lymph nodes, and cavity shave margins were summarized as the last topics covered in this review.
Biomedical Research/*trends ; Breast Neoplasms/therapy ; Combined Modality Therapy ; Dioxoles ; Endometrial Neoplasms/therapy ; Female ; Genital Neoplasms, Female/genetics/*therapy ; Humans ; Immunotherapy ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Ovarian Neoplasms/prevention & control/therapy ; Papillomavirus Vaccines ; Precision Medicine ; Tetrahydroisoquinolines ; Uterine Cervical Neoplasms/prevention & control/therapy/virology ; Uterine Neoplasms/therapy

Hepatocellular carcinoma (HCC) is the second most common cause of cancer death worldwide. This cancer commonly arises against a background of chronic liver disease. As a result, a patient with HCC requires multidisciplinary care. Treatment options vary widely based on tumor burden and metastases. The most widely utilized staging system is the Barcelona Clinic Liver Cancer staging system, which recommends treatments based on tumor size and the underlying liver disease and functional status of the patient. Treatment options range from surgical resection or transplantation to locoregional therapies with modalities such as radiofrequency ablation and transarterial chemoembolization to systemic chemotherapies. Future care involves the development of combination therapies that afford the best tumor response, further clarification of the patients best suited for therapies and the development of new oral chemotherapeutic agents.
Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/pathology/*therapy ; Catheter Ablation/trends ; Chemoembolization, Therapeutic/trends ; Combined Modality Therapy/trends ; Forecasting ; Humans ; Liver Neoplasms/pathology/*therapy ; Liver Transplantation ; Neoplasm Staging/methods

Chinese medicine (CM) has been used in the treatment of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) for 30 years and the demonstrated therapeutic effects of CM, such as reducing plasma HIV viral load, increasing CD4(+)T cell counts, promoting immunity reconstitution, ameliorating symptoms and signs, improving the health related quality of life (HRQOL) and counteracting against the effects of anti-retroviral drugs, were summarized and reviewed in this article. The authors point out that it had been a good opportunity to use CM for the treatment of HIV infection and AIDS in the past and also there are huge challenges ahead for CM research and clinicians to discover more effective CM and its underlying mechanisms for treatment of AIDS.
Acquired Immunodeficiency Syndrome ; complications ; therapy ; Antiretroviral Therapy, Highly Active ; adverse effects ; utilization ; China ; Combined Modality Therapy ; Drug-Related Side Effects and Adverse Reactions ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; trends ; Palliative Care ; methods ; Quality of Life ; Treatment Outcome

Gastric cancer remains one of the most common causes of cancer-related death in China. Radical operation is the only potentially curative therapy for advanced gastric cancer (AGC). D2 radical gastrectomy has been widely accepted as a standard surgical procedure for patients with AGC in China. Several clinical trials have revealed that more extended resection than D2 surgery has no impact on survival. In order to improve the prognosis of AGC patients, it is necessary to carry out the preoperative TNM staging for selecting a reasonable therapeutical modality before surgery. Multimodality treatment involving perioperative chemotherapy, radiotherapy or molecular targeting agents in addition to surgery have been thought to be promising treatment strategy. In this article, we present an update on the current literature regarding the trends of surgical multimodal treatment for the patients with AGC.
Combined Modality Therapy ; trends ; Humans ; Stomach Neoplasms ; surgery

Biomedical Research ; methods ; Combined Modality Therapy ; methods ; trends ; Delivery of Health Care, Integrated ; methods ; Geography ; Humans ; Medicine, Chinese Traditional ; methods ; Patient Care Planning ; trends ; Patient-Centered Care ; methods ; trends ; Western World

Academies and Institutes ; organization & administration ; China ; Combined Modality Therapy ; methods ; trends ; Drugs, Chinese Herbal ; therapeutic use ; Education, Medical, Continuing ; Humans ; Integrative Medicine ; legislation & jurisprudence ; trends ; International Cooperation ; Medicine, Chinese Traditional ; methods ; trends ; Western World