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Approximately 1 million individuals develop gastric cancer (GC) every year and the mortality of gastric cancer is only second to lung cancer.Based on the published literature, treatment guidelines and reports from international meetings, we here review the current treatment options for GC and discuss insights and perspectives from the latest clinical studies.Apart from the elueidation of underlying molecular and genetic ehanges in the development and progression of GC, the development of new treatment strategies is critical for the improvement of the treatment and prognosis of these patients.In this review we have summarized and critically assessed recent studies dealing with the chemotherapy of advanced GC.The most extensively studied drugs as single agents are 5-fluorouracil,cisplatin, doxornbiein, epirubicin, mitomycin C and etoposide.Newer chemotherapeutic agents include the taxanes (docetaxel and paclitaxel), oral fluoropyrimidines (capeeitabine and S-l), oxaliplatin and irinotecan.The response rates have generally been moderate and there is no consensus on the optimal combination of eytotoxie agents and the potential role of more recently developed "targeted therapies" (cetuximab, bevacizumab).Progress in the medical oncological treatment of GC has resulted from advances in tumor biology as well as randomized clinical trials.