Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology

Abstract

Gastric cancer is the third leading cause of cancer-related deaths worldwide. Over 95% of gastric cancers are adenocarcinomas, which are typically classified based on anatomic location and histologic type. Gastric cancer generally carries a poor prognosis because it is often diagnosed at an advanced stage. Systemic therapy can provide palliation, improved survival, and enhanced quality of life in patients with locally advanced or metastatic disease. The implementation of biomarker testing, especially analysis of HER2 status, microsatellite instability (MSI) status, and the expression of programmed death-ligand 1 (PD-L1), has had a significant impact on clinical practice and patient care. Targeted therapies including trastuzumab, nivolumab, and pembrolizumab have produced encouraging results in clinical trials for the treatment of patients with locally advanced or metastatic disease. Palliative management, which may include systemic therapy, chemoradiation, and/or best supportive care, is recommended for all patients with unresectable or metastatic cancer. Multidisciplinary team management is essential for all patients with localized gastric cancer. This selection from the NCCN Guidelines for Gastric Cancer focuses on the management of unresectable locally advanced, recurrent, or metastatic disease.

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Affiliated Institutions

• UCSF Helen Diller Family Comprehensive Cancer Center US
• Breast Cancer Research Foundation US
• University of Tennessee Health Science Center US
• City Of Hope National Medical Center US
• Duke Cancer Institute
• O'Neal Comprehensive Cancer Center
• Dana-Farber Brigham Cancer Center US
• Sidney Kimmel Comprehensive Cancer Center US
• University of California, Davis US
• Stanford Cancer Institute
• The University of Texas MD Anderson Cancer Center US
• Barnes-Jewish Hospital US
• University of Pennsylvania US
• St. Jude Children's Research Hospital US
• Susan Thompson Buffett Foundation US
• Seattle Cancer Care Alliance US
• Harold C. Simmons Comprehensive Cancer Center
• Cancer Research Center US
• Fred and Pamela Buffett Cancer Center
• Vanderbilt-Ingram Cancer Center
• Smilow Cancer Hospital US
• Cleveland Clinic US
• Massachusetts General Hospital US
• The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute US
• University of Colorado Cancer Center US
• Fred Hutch Cancer Center US
• Moores Cancer Center
• University of California, San Diego US
• University of Michigan US
• Cape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South Africa ZA
• University of Colorado Denver US
• University Hospitals Seidman Cancer Center US
• Moffitt Cancer Center US
• UCLA Jonsson Comprehensive Cancer Center
• Fox Chase Cancer Center US
• The University of Texas Southwestern Medical Center US
• Robert H. Lurie Comprehensive Cancer Center of Northwestern University
• University of Wisconsin Carbone Cancer Center US
• Cancer Institute (WIA) IN
• UC Davis Comprehensive Cancer Center
• Jewish Hospital US
• Kettering University US
• Memorial Sloan Kettering Cancer Center US
• National Comprehensive Cancer Network

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