Targeted therapy for stomach cancer

Targeted therapy is sometimes used to treat stomach cancer. It uses drugs to target specific molecules (such as proteins) on the surface of cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. Targeted therapy may also be called molecular targeted therapy.

Targeted therapy is used to:

  • kill stomach cancer cells
  • treat advanced or recurrent stomach cancer in combination with chemotherapy

Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of targeted therapy. You may also receive other treatments.

Targeted therapy drugs used for stomach cancer

Trastuzumab (Herceptin) and ramucirumab (Cyramza) are targeted therapy drugs used to treat stomach cancer.

Trastuzumab

Trastuzumab is designed to attach to extra proteins on the surface of some stomach cancer cells. It stops the growth of the cancer in people with HER2-positive stomach cancer. About 1 in 5 people with stomach cancer have too much of the HER2 protein. This is called overexpression of HER2.

People with HER2-negative stomach cancer don’t benefit from trastuzumab.

Trastuzumab is given as an intravenous (IV) drug injected into a vein. It is often given every 2 or 3 weeks along with the chemotherapy drugs cisplatin (Platinol AQ) and either 5-fluorouracil (Adrucil, 5-FU) or capecitabine (Xeloda).

Ramucirumab

Ramucirumab (Cyramza) is a monoclonal antibody that targets a substance called vascular endothelial growth factor (VEGF). VEGF helps cells form new blood vessels that carry oxygen and nutrients, which cells need to grow and develop.

Many tumour cells, including stomach cancer cells, make VEGF. Ramucirumab works by finding and attaching to VEGF and preventing cells from forming new blood vessels. This means the cells can’t get oxygen and nutrients that they need to grow. Targeted therapy drugs like ramucirumab are also called anti-angiogenesis drugs because they stop new blood vessels from forming.

Ramucirumab is given intravenously every 2 weeks. It may be given alone or combined with the chemotherapy drug paclitaxel (Taxol). Ramucirumab is used for advanced, metastatic or recurrent stomach cancer when other chemotherapy drugs no longer seem to be working (are refractory to treatment).

Information about specific cancer drugs

Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.

Questions to ask about targeted therapy

Find out more about targeted therapy. To make the decisions that are right for you, ask your healthcare team questions about targeted therapy.

Expert review and references

  • Alberta Health Services. Gastric Cancer. Alberta Health Services; 2013.
  • Alberts SR & Grothey A . Gastrointestinal tract cancers. Casciato DA & Territo MC (eds.). Manual of Clinical Oncology. 7th ed. Lippincott Williams & Wilkins; 2012: 9: pp. 227-284.
  • American Society of Clinical Oncology (ASCO). Stomach cancer. Alexandria, VA.: American Society of Clinical Oncology (ASCO); 2014.
  • Avital, I. et al . Cancer of the stomach. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011: 80: pp. 924-954.
  • BC Cancer Agency (BCCA). Stomach Cancer Management Guidelines. BC Cancer Agency; 2013: http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/Gastrointestinal/02.Stomach/default.htm.
  • Czito BG, Palta M & Willett CG . Stomach cancer. Halperin EC, Wazer DE, Perez CA et al. Perez and Brady's Principles and Practice of Radiation Oncology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013: 58.
  • Health Canada. Cyramza Summary Basis of Decision (SBD). 2015: http://www.hc-sc.gc.ca/dhp-mps/prodpharma/sbd-smd/drug-med/sbd_smd_2015_cyramza_176810-eng.php.
  • Kelsen, D. P., Van De Velde, C. J. H., & Minsky, B. D . Gastric cancer: clinical management. Kelsen, D. P., Daly, J. M., Kern, S. E., Levin, B., Tepper, J. E., & Van Cutsem, E. (eds.). Principles and Practice of Gastrointestinal Oncology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2008: 23: pp. 285-316.
  • Knight G, Earle CC, Cosby R, et al . Neoadjuvant or Adjuvant Therapy for Resectable Gastric Cancer. Cancer Care Ontario. Evidence-Based Series (EBS) and Practice Guidelines (PG). Toronto, ON: Cancer Care Ontario; 2013.
  • National Comprehensive Cancer Network. Gastric Cancer (Version 1.2014). National Comprehensive Cancer Network; 2014.
  • Russell MC, Hsu C & Mansfield PF . Primary gastric malignancies. Feig BW & Ching CD. The MD Anderson Surgical Oncology Handbook. 5th ed. Lippincott Williams & Wilkins; 2012: 9: pp. 270-315.
  • Yao JC, Crane CH, Sano T, et al . Carcinoma of the stomach. Hong WK, et al (eds.). Holland Frei Cancer Medicine. 8th ed. People's Medical Publishing House; 2010: 84: pp. 1086-1108.

Side effects of targeted therapy for stomach cancer

Targeted therapy has fewer side effects than other treatments. Learn about side effects of targeted therapy for stomach cancer and how they are managed.