Abstract：
Gastric cancer (GC) is the fifth most common cancer worldwide with a varied geographic distribution and an aggressive behavior. In Spain, the incidence is lower and GC represents the tenth most frequent tumor and the seventh cause of cancer mortality. Molecular biology knowledge allowed to better profile patients for a personalized therapeutic approach. In the localized setting, the multidisciplinary team discussion is fundamental for planning the therapeutic approach. Endoscopic resection in very early stage, perioperative chemotherapy in locally advanced tumors, and chemoradiation + surgery + adjuvant immunotherapy for the GEJ are current standards. For the metastatic setting, biomarker profiling including Her2, PD-L1, MSS status is needed. Chemotherapy in combination with checkpoint inhibitors had improved the outcomes for patients with PD-L1 expression. Her2 positive patients should receive antiHer2 therapy added to chemotherapy. We describe the different evidences and recommendations based on the literature.
摘要：
胃癌（GC）是全球第五大最常见的癌症，具有不同的地理分布和攻击行为。在西班牙,发病率较低，GC是第10位最常见的肿瘤和第7位癌症死亡原因。分子生物学知识可以更好地描述患者的个性化治疗方法。在本地化设置中，多学科团队讨论是规划治疗方法的基础.早期内镜切除，局部晚期肿瘤的围手术期化疗，GEJ的放化疗+手术+辅助免疫疗法是现行标准。对于转移性设置，需要包括Her2、PD-L1、MSS状态的生物标志物谱分析。化疗联合检查点抑制剂改善了PD-L1表达患者的预后。Her2阳性患者应接受抗Her2治疗并加入化疗。我们根据文献描述了不同的证据和建议。
