Gastric cancer represents a challenging health problem around the world and is one of the top causes of cancer-related deaths. Challenges in treatment of advanced gastric cancer are due to the relative resistance of disease to treatment, the frequent occurrence of symptomatic disease or impaired performance status of patients, and the propensity of gastric cancer to present when it has become locally advanced or metastatic. Recently, remarkable progress in tumor biology has led to the development of new agents that target critical aspects of oncogenic pathways. This review provides an updated summary of the current status of gastric cancer diagnosis, management, cytotoxic chemotherapy, emphasize on many chemotherapeutic options available and the reasoning that clinicians use in choosing the right treatment option for the right patient. As per the current clinical trial studies the combination therapy shows promising success rate, Pac-5-FU(56%), Cape-Cis(55%), DCF(54%), UFT-Cis(51%), CPT-Cis(50%), 5-FU-Oxal(48%), FOLFOX-4(45%). The advances in individualization of therapy offer a treatment care plan with a high rate of success and minimal toxicity. Recent progress in treatment of gastric cancer includes biologically targeted therapies (a recombinant humanized monoclonal antibody to vascular endothelial growth factor), Monoclonal Antibodies and tyrosine kinase Inhibitors, predictive markers of response, surrogate markers of response, use of nanotechnology whose scope will only increase as the understanding of the pathophysiology and carcinogenesis of this disease improves.
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