Conversion therapy for stage Ⅳ gastric cancer

Gastric cancer(GC)is one of the most common malignant tumors and represents the fourth most common cause of cancer death worldwide.Surgery is the optimal treatment for patients with GC.However,70％-80％of GC patients are diagnosed at locally advanced stages.A large number of clinical studies have shown that no existing treatment has ideal efficacy against advanced unresectable GC with No.16 lymph nodes or distant organ metas-tasis,and the median survival time of patients is only approxi-mately 10 months.In recent years,conversion therapy has shown great promise.This approach consists mainly of developing reasonable comprehensive treatment programs,including chemotherapy,radiotherapy,and targeted therapy delivered by a multidisciplinary team(MDT),to convert initially unresectable GC to resectable cancer,thus prolonging patients'survival and improving their quality of life.Here,we aim to discuss the treat-ment strategies,challenges and opportunities of conversion ther-apy for GC,along with our experience in conversion therapy for patients with advanced GC(Fig.1).