Chemotherapy and targeted therapy are options to treat stomach cancer. Chemotherapy uses drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body to the cancer cells. Targeted therapy uses medications to attack or block specific factors that help cancer cells grow. It may help increase survival time and increase time to recurrence.

Chemotherapy

Chemotherapy for stomach cancer is most often used in combination with radiation therapy (called chemoradiation). Chemotherapy may be used:

• Before surgery —to shrink the tumor and decrease the amount of tissue that needs to be removed
• After surgery—to kill any remaining cancer cells and decrease the risk of return
• To help relieve symptoms of metastatic cancer and extend survival time

Targeted Therapy

Unlike chemotherapy, targeted therapy drugs are designed to attack cancer cells with little to no damage to healthy cells. They may be used in combination with standard chemotherapy, as a primary treatment, or if other treatment methods fail. Targeted therapy drugs for stomach cancer include:

• Trastuzumab—To stop tumor growth in cancers with an excess amount of a protein called human growth factor receptor (HER2). HER2 is an oncogene that spurs the growth of certain tumors.
• Ramucirumab and bevacizumab—Blocks the development of new blood vessels that feed tumor growth.

Common side effects include:

• Fever
• Diarrhea
• Fatigue
• Headache
• High blood pressure
• Slow wound healing (ramucirumab, bevacizumab)
• Bleeding (bevacizumab)

Managing Side Effects

A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemo- and/or targeted therapy regimens may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.