Chemical Therapy

  • Kequn Xu
  • Yang Yang
  • Qin Huang
  • Hua Jiang
  • Valia Boosalis


Because of the absence of a universally accepted chemotherapy protocol for gastric cardiac cancer, each patient needs to be managed individually by a multidisciplinary team. Since the liver remains the most common site of metastasis in patients with gastric cardiac cancer, adjuvant chemotherapy is needed to improve prognosis. Recent results of clinical trials suggest that neoadjuvant chemotherapy is better than post-resection chemotherapy because of reduction of the tumor stage. Molecular precision target therapy on HER2, PD-1, and PD-L1 molecules has been shown to be highly promising in treatment of this cancer with improved outcomes. There is an urgent need for randomized, multicenter, well-controlled studies to establish universally accepted optimal therapy guidelines for this cancer.


Gastric cancer Stomach Cancer Gastric cardia HER2 PD-L1 


  1. 1.
    Yamashita H, Katai H, Morita S, et al. Optimal extent of lymph node dissection for Siewert type II esophagogastric junction carcinoma. Ann Surg. 2011;254(2):274–80.CrossRefPubMedGoogle Scholar
  2. 2.
    Wayman J, Bennett MK, Raimes SA, et al. The pattern of recurrence of adenocarcinoma of the oesophago-gastric junction. Br J Cancer. 2002;86(8):1223–9.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357(18):1810–20.CrossRefPubMedGoogle Scholar
  4. 4.
    Sasako M, Sakuramoto S, Katai H, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol. 2011;29(33):4387–93.CrossRefPubMedGoogle Scholar
  5. 5.
    Bang Y-J, Kim Y-W, Yang H-K, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet. 2012;379(9813):315–521.CrossRefPubMedGoogle Scholar
  6. 6.
    Paoletti X, Oba K, Burzykowski T, et al. Benefit of adjuvant chemotherapy for resectable gastric cancer: a meta-analysis. JAMA. 2010;303(17):1729–37.CrossRefPubMedGoogle Scholar
  7. 7.
    Hosoda K, Yamashita K, Katada N, et al. Benefit of neoadjuvant chemotherapy for Siewert type II esophagogastric junction adenocarcinoma. Anticancer Res. 2015;35(1):419–25.PubMedGoogle Scholar
  8. 8.
    Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11–20.CrossRefPubMedGoogle Scholar
  9. 9.
    Ychou M, Boige V, Pignon JP, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol. 2011;29(143):1715–21.CrossRefPubMedGoogle Scholar
  10. 10.
    Li W, Qin J, Sun YH, et al. Neoadjuvant chemotherapy for advanced gastric cancer: a meta-analysis. World J Gastroenterol. 2010;16(44):5621–8.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345(10):725–30.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Lee J, Limdo H, Kim S, et al. Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial. J Clin Oncol. 2012;30(3):268–73.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Smalley SR, Benedetti JK, Haller DG, et al. Updated analysis of SWOG-directed intergroup study 0116: a phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J Clin Oncol. 2012;30(19):2327–33.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Urba SG, Orringer MB, Turrisi A, et al. Randomized trial of preoperative chemoradiation versus surgery alone in patients with locoregional esophageal carcinoma. J Clin Oncol. 2001;19(2):305–13.CrossRefPubMedGoogle Scholar
  15. 15.
    Burmeister BH, Smithers BM, Gebski V, et al. Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial. Lancet Oncol. 2005;6(9):659–68.CrossRefPubMedGoogle Scholar
  16. 16.
    Walsh TN, Noonan N, Hollywood D, et al. A comparison of multimodal therapy and surgery for esophageal adenocarcinoma. N Engl J Med. 1996;335(7):462–7.CrossRefPubMedGoogle Scholar
  17. 17.
    Tepper J, Krasna MJ, Niedzwiecki D, et al. Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer: CALGB 9781. J Clin Oncol. 2008;26(7):1086–92.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Burmeister BH, Thomas JM, Burmeister EA, et al. Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase II trial. Eur J Cancer. 2011;47(3):354–60.CrossRefPubMedGoogle Scholar
  19. 19.
    van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074–84.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Fiorica F, Di Bona D, Schepis F, et al. Preoperative chemoradiotherapy for oesophageal cancer: a systematic review and meta-analysis. Gut. 2004;53(7):925–30.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Gebski V, Burmeister B, Smithers BM, et al. Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis. Lancet Oncol. 2007;8(3):226–34.CrossRefPubMedGoogle Scholar
  22. 22.
    Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. Lancet Oncol. 2011;12:681–92.CrossRefPubMedGoogle Scholar
  23. 23.
    Stahl M, Walz MK, Stuschke M, et al. Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol. 2009;27(6):851–6.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Bombi JA, Riverola A, Bordas JM, et al. Adenosquamous carcinoma of the esophagus: a case report. Pathol Res Pract. 1991;187(4):519–21.Google Scholar
  25. 25.
    Yachida S, Nakanishi Y, Shimoda T, et al. Adenosquamous carcinoma of the esophagus. Clinicopathologic study of 18cases. Oncology. 2004;66(3):218–25.CrossRefPubMedGoogle Scholar
  26. 26.
    Maeda H, Matsumura A, Kawabata T, et al. Japan National Hospital Organization Study Group for Lung Cancer. Adenosquamous carcinoma of the lung: surgical results as compared with squamous cell and adenocarcinoma cases. Eur J Cardiothorac Surg. 2012;41(2):357–61.CrossRefPubMedGoogle Scholar
  27. 27.
    Boyd CA, Benarroch-Gampel J, Sheffield KM, et al. 415 Patients with adenosquamous carcinoma of the pancreas: a population-based analysis of prognosis and survival. J Surg Res. 2012;174(1):12–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Baek MH, Park JY, Kim D, et al. Comparison of adenocarcinoma and adenosquamous carcinoma in patients with early-stage cervical cancer after radical surgery. Gynecol Oncol. 2014;135(3):462–7.CrossRefPubMedGoogle Scholar
  29. 29.
    Sun YH, Lin SW, Chen CH, Liang WY, Hsieh CC, et al. Adenosquamous carcinoma of the esophagus and esophagogastric junction: clinical manifestations and treatment outcomes. J Gastrointest Surg. 2015;19(7):1216–22.CrossRefPubMedGoogle Scholar
  30. 30.
    Huang Q, Wu HY, Nie L, et al. Primary high-grade neuroendocrine carcinoma of the esophagus: a clinicopathologic and immunohistochemical study of 42 resection cases. Am J Surg Pathol. 2013;37(4):467–83.CrossRefPubMedGoogle Scholar
  31. 31.
    Law SY, Fok M, Lam KY, et al. Small cell carcinoma of the esophagus. Cancer. 1994;73(12):89–94.CrossRefGoogle Scholar
  32. 32.
    Huang Q, Zhang LH. The histopathologic spectrum of carcinomas involving the gastroesophageal junction in the Chinese. Int J Surg Pathol. 2007;15:38–52.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Huang Q, Fan XS, Agoston AT, et al. Comparison of gastroesophageal junction carcinomas in Chinese versus American patients. Histopathology. 2011;59(2):188–97.CrossRefPubMedGoogle Scholar
  34. 34.
    Richards D, Davis D, Yan P, et al. Unusual case of small cell gastric carcinoma: case report and literature review. Dig Dis Sci. 2011;56(4):951–7.CrossRefPubMedGoogle Scholar
  35. 35.
    Brenner B, Tang LH, Shia J, et al. Small cell carcinoma of the gastrointestinal tract: clinicopathological features and treatment approach. Semin Oncol. 2007;34(1):43–50.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Liu H, Xie YB, Xu Q, et al. Clinical analysis of 17 cases of gastric small cell carcinoma. Zhonghua Zhong Liu Za Zhi. 2013;35(4):292–4.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Matsunaga M, Miwa K, Noguchi T, et al. Small cell carcinoma of gastro-oesophageal junction with remarkable response to chemo-radiotherapy. BMJ Case Rep. 2012;2012.
  38. 38.
    Xin K, Wei J, Wang H, et al. Neoadjuvant chemotherapy followed by D2 gastrectomy and esophagojejunal Roux-en-Y anastomosis in gastric small cell carcinoma: a case report. Oncol Lett. 2014;8(6):2549–52.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Ziauddin MF, Rodriguez HE, Quiros ED, et al. Carcinosarcoma of the esophagus: pattern of recurrence. Dig Surg. 2001;18(3):216–8.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Yamazaki K. A gastric carcinosarcoma with neuroendocrine cell differentiation and undifferentiated spindle-shaped sarcoma component possibly progressing from the conventional tubular adenocarcinoma; an immunohistochemical and ultrastructural study. Virchows Arch. 2003;442(1):77–81.PubMedGoogle Scholar
  41. 41.
    Solerio D, Ruffini E, Camandona M, et al. Carcinosarcoma of the esophagogastric junction. Tumori. 2008;94(3):416–8.CrossRefPubMedGoogle Scholar
  42. 42.
    Watanabe H, Enjoji M, Imai T. Gastric carcinoma with lymphoid stroma. Its morphologic characteristics and prognostic correlations. Cancer. 1976;38(1):232–43.CrossRefPubMedGoogle Scholar
  43. 43.
    Murphy G, Pfeiffer R, Camargo MC, et al. Meta-analysis shows that prevalence of Epstein-Barr virus-positive gastric cancer differs based on sex and anatomic location. Gastroenterology. 2009;137(3):824–33.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Lim H, Park YS, Lee JH, et al. Features of gastric carcinoma with lymphoid stroma associated with Epstein-Barr virus. Clin Gastroenterol Hepatol. 2015;13(10):1738–44.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Matsunou H, Konishi F, Hori H, et al. Characteristics of Epstein-Barr virus-associated gastric carcinoma with lymphoid stroma in Japan. Cancer. 1996;77(10):1998–2004.CrossRefPubMedGoogle Scholar
  46. 46.
    Murray PG, Billingham LJ, Hassan HT, et al. Effect of Epstein-Barr virus infection on response to chemotherapy and survival in Hodgkin’s disease. Blood. 1999;94(2):442–7.PubMedGoogle Scholar
  47. 47.
    Nakamura S, Matsumoto T, Iida M, et al. Primary gastrointestinal lymphoma in Japan: a clinicopathologic analysis of 455 patients with special reference to its time trends. Cancer. 2003;97(10):2462–73.CrossRefPubMedGoogle Scholar
  48. 48.
    Nakamura S, Sugiyama T, Matsumoto T, et al. Long-term clinical outcome of gastric MALT lymphoma after eradication of Helicobacter pylori: a multicentre cohort follow-up study of 420 patients in Japan. Gut. 2012;61(4):507–13.CrossRefPubMedGoogle Scholar
  49. 49.
    Zullo A, Hassan C, Cristofari F, et al. Effects of Helicobacter pylori eradication on early stage gastric mucosa-associated lymphoid tissue lymphoma. Clin Gastroenterol Hepatol. 2010;8(2):105–10.CrossRefPubMedGoogle Scholar
  50. 50.
    Ruskoné-Fourmestraux A, Fischbach W, Aleman BMP, et al. EGILS consensus report. Gastric extranodal marginal zone B cell lymphoma of MALT. Gut. 2011;60(6):747–58.CrossRefPubMedGoogle Scholar
  51. 51.
    Raderer M, Streubel B, Wöhrer S, et al. Successful antibiotic treatment of Helicobacter pylori negative gastric mucosa associated lymphoid tissue lymphomas. Gut. 2006;55(5):616–8.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Al-Taie O, Al-Taie E, Fischbach W. Patients with Helicobacter pylori negative gastric marginal zone B-cell lymphoma (MZBCL) of MALT have a good prognosis. Z Gastroenterol. 2014;52(12):1–5.Google Scholar
  53. 53.
    Fischbach W, Goebeler-Kolve ME, Dragosics B, et al. Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication: experience from a large prospective series. Gut. 2004;53(1):34–7.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Wündisch T, Thiede C, Morgner A, et al. Long-term follow-up of gastric MALT lymphoma after Helicobacter pylori eradication. J Clin Oncol. 2005;23(31):8018–24.CrossRefPubMedGoogle Scholar
  55. 55.
    Wündisch T, Dieckhoff P, Greene B, et al. Second cancers and residual disease in patients treated for gastric mucosa-associated lymphoid tissue lymphoma by Helicobacter pylori eradication and followed for 10 years. Gastroenterology. 2012;143(4):936–42.CrossRefPubMedGoogle Scholar
  56. 56.
    Copie-Bergman C, Gaulard P, Lavergne-Slove A, et al. Proposal for a new histological grading system for post-treatment evaluation of gastric MALT lymphoma. Gut. 2003;52(11):1656.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Koch P, Probst A, Berdel WE, et al. Treatment results in localized primary gastric lymphoma: data of patients registered within the German multicenter study (GIT NHL 02/96). J Clin Oncol. 2005;23(28):7050–9.CrossRefPubMedGoogle Scholar
  58. 58.
    Tsang RW, Gospodarowicz MK, Pintilie M. Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. J Clin Oncol. 2003;21(22):4157–64.CrossRefPubMedGoogle Scholar
  59. 59.
    Rummel MJ, Niederle N, Maschmeyer G, et al. Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicentre, randomised, phase3 non-inferiority trial. Lancet. 2013;381(9873):1203–10.CrossRefPubMedGoogle Scholar
  60. 60.
    Fischbach W. MALT lymphoma: forget surgery? J Dig Dis. 2013;31(1):38–42.CrossRefGoogle Scholar
  61. 61.
    Akamatsu T, Mochizuki T, Okiyama Y, et al. Comparison of localized gastric mucosa associated lymphoid (MALT) lymphoma with and without Helicobacter pylori infection. Helicobacter. 2006;11(2):86–95.CrossRefPubMedGoogle Scholar
  62. 62.
    Chung SJ, Kim JS, Kim H, et al. Long-term clinical outcome of Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma is comparable to that of H. pylori-positive lymphoma. J Clin Gastroenterol. 2009;43(4):312–7.CrossRefPubMedGoogle Scholar
  63. 63.
    Park HS, Kim YJ, Yang WI, et al. Treatment outcome of localized Helicobacter pylori-negative low-grade gastric MALT lymphoma. World J Gastroenterol. 2010;16(17):2158–62.CrossRefPubMedPubMedCentralGoogle Scholar
  64. 64.
    Fischbach W, Malfertheiner P, Hoffmann JC, et al. S3-guideline “helicobacter pylori and gastroduodenal ulcer disease” of the German society for digestive and metabolic diseases (DGVS) in cooperation with the German society for hygiene and microbiology, society for pediatric gastroenterology and nutrition e.V., German society for rheumatology, AWMF-registration-no. 021/001. Z Gastroenterol. 2009;47(12):1230–63.CrossRefPubMedGoogle Scholar
  65. 65.
    Morgner A, Miehlke S, Fischbach W, et al. Complete remission of primary high-grade B-cell gastric lymphoma after cure of Helicobacter pylori infection. J Clin Oncol. 2001;19(7):2041–8.CrossRefPubMedGoogle Scholar
  66. 66.
    Kuo SH, Yeh KH, Wu MS. Helicobacter pylori eradication therapy is effective in the treatment of early-stage H. pylori-positive diffuse large B-cell lymphomas. Blood. 2012;119(21):4838–44.CrossRefPubMedGoogle Scholar
  67. 67.
    NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin’s lymphomas, version 2.2012.
  68. 68.
    Tanner M, Hollmen M, Junttila TT, et al. Amplification of HER-2 in gastric carcinoma: association with Topoisomerase IIalpha gene amplification, intestinal type, poor prognosis and sensitivity to trastuzumab. Ann Oncol. 2005;16(2):273–8.CrossRefPubMedGoogle Scholar
  69. 69.
    Gravalos C, Jimeno A. HER2 in gastric cancer: a new prognostic factor and a novel therapeutic target. Ann Oncol. 2008;19(9):1523–9.CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Hofmann M, Stoss O, Shi D, et al. Assessment of a HER2 scoring system for gastric cancer: results from a validation study. Histopathology. 2008;52(7):797–805.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Van Cutsem E, Bang YJ, Feng-Yi F, et al. HER2 screening data from ToGA: targeting HER2 in gastric and gastroesophageal junction cancer. Gastric Cancer. 2015;18(3):476–84.CrossRefPubMedGoogle Scholar
  72. 72.
    Bang Y, Chung H, Xu J, et al. Pathological features of advanced gastric cancer (GC): relationship to human epidermal growth factor receptor 2 (HER2) positivity in the global screening programme of the ToGA trial. J Clin Oncol. 2009;20(27):4556.Google Scholar
  73. 73.
    Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376(9742):687–97.CrossRefPubMedPubMedCentralGoogle Scholar
  74. 74.
    Gong J, Liu T, Fan Q, et al. Optimal regimen of trastuzumab in combination with oxaliplatin/capecitabine in first-line treatment of HER2-positive advanced gastric cancer (CGOG1001): a multicenter, phase II trial. BMC Cancer. 2016;16:68. Scholar
  75. 75.
    Van Cutsem E, Kang Y, Chung H, et al. Efficacy results from the ToGA trial: a phase III study of trastuzumab added to standard chemotherapy (CT) in first-line human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer (GC). J Clin Oncol. 2009;20(27):LBA4509.CrossRefGoogle Scholar
  76. 76.
    Fuchs CS, Tomasek J, Yong CJ, et al. Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2014;383(9911):31–9.CrossRefPubMedGoogle Scholar
  77. 77.
    Wilke H, Muro K, Van Cutsem E, et al. Ramucirumab plus paclitaxel in patients with previously treated advanced gastric or gastrooesophageal junction adenocarcinoma (RAINBOW): a double-blind, randomised phase 3 trial. Lancet Oncol. 2014;15(11):1224–35.CrossRefPubMedGoogle Scholar
  78. 78.
    Tian S, Quan H, Xie C, et al. YN968D1 is a novel and selective inhibitor of vascular endothelial growth factor receptor-2 tyrosine kinase with potent activity in vitro and in vivo. Cancer Sci. 2011;102(7):1374–80.CrossRefPubMedGoogle Scholar
  79. 79.
    Li J, Qin S, Xu J, et al. Randomized, double-blind, placebo-controlled phase III trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction. J Clin Oncol. 2016;34(13):1448–54.CrossRefPubMedGoogle Scholar
  80. 80.
    Ajani JA, Lee J, Sano T, et al. Gastric adenocarcinoma. Nat Rev Dis Primers. 2017;3:17036.CrossRefPubMedGoogle Scholar
  81. 81.
    Alexandrov LB, Nik-Zainal S, Wedge DC, et al. Signatures of mutational processes in human cancer. Nature. 2013;500(7463):415–21.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Charles SF, Toshihiko D, Raymond WJJ, et al. KEYNOTE-059 cohort 1: efficacy and safety of pembrolizumab (pembro) monotherapy in patients with previously treated advanced gastric cancer. J Clin Oncol. 2017;35(suppl; abstract):4003.Google Scholar
  83. 83.
    Yung-Jue B, Kei M, Charles SF, et al. KEYNOTE-059 cohort 2: safety and efficacy of pembrolizumab (pembro) plus 5-fluorouracil (5-FU) and cisplatin for first-line (1L) treatment of advanced gastric cancer. J Clin Oncol. 2017;35(suppl; abstract):4012.Google Scholar
  84. 84.
    Kang YK, Satoh T, Ryu MH, et al. Nivolumab (ONO-4538/BMS-936558) as salvage treatment after second or later-line chemotherapy for advanced gastric or gastro-esophageal junction cancer (AGC): a double-blinded, randomized, phase III trial. J Clin Oncol. 2017;35(suppl 4S):2–2.CrossRefGoogle Scholar
  85. 85.
    Yelena Y, Patrick AO, Emiliano C, et al. Nivolumab ± ipilimumab in patients with advanced/metastatic chemotherapy refractory (CTx-R) gastric (G), esophageal (E), or gastroesophageal junction (GEJ) cancer: CheckMate 032 study. J Clin Oncol. 2017;35(suppl; abstract):4014.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Kequn Xu
    • 1
  • Yang Yang
    • 2
  • Qin Huang
    • 3
    • 4
  • Hua Jiang
    • 1
  • Valia Boosalis
    • 5
  1. 1.Department of Oncologythe Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical UniversityChangzhouPeople’s Republic of China
  2. 2.Nanjing Drum Tower Hospital, Nanjing UniversityNanjingPeople’s Republic of China
  3. 3.Pathology and Laboratory MedicineVeterans Affairs Boston Healthcare SystemWest RoxburyUSA
  4. 4.Harvard Medical School and Brigham and Women’s HospitalBostonUSA
  5. 5.Department of HematologyVA Boston Healthcare SystemJamaica PlainUSA

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