Standard of care for advanced and metastatic gastric and gastro-oesophageal junction adenocarcinoma relies on palliative systemic therapy that can improve both survival and quality of life of patients. In first-line, platinum – fluoropyrimidine-based doublet (combined with trastuzumab for HER2/neu positive tumours) or triplet chemotherapy regimen (mainly combining a taxane) is now standard option. For fit patients, a secondline with taxane and/or ramucirumab or irinotecan monotherapy, is an option. Latest studies showed interest for new treatments such as immune checkpoint inhibitors (anti-PD-1) or trifluridine/tipiracil in some situations.

(BELG J MED ONCOL 2020;14(4):146–50)