Overview
For patients with gastric cancer — particularly those with locally advanced, metastatic, or recurrent disease — medical oncology plays a central role in treatment. Chemotherapy, targeted therapy, and immunotherapy, used alone or in combination, can shrink tumors, control disease progression, and in some cases convert initially unresectable disease to a surgically curable state.
Shanghai's leading medical oncologists are internationally trained and at the forefront of clinical research, offering patients access to the latest systemic treatment protocols and clinical trials. China Medical Concierge Shanghai (CMCS) connects international patients with these specialists for expert, personalized oncology care.
Understanding Gastric Cancer
What Is Gastric Cancer?
Gastric cancer develops in the lining of the stomach and is one of the most common cancers in East Asia. China accounts for nearly 44% of global gastric cancer cases. While surgery is the primary curative treatment for early and locally advanced disease, medical oncology — systemic drug therapy — is essential for most patients, either as perioperative treatment, adjuvant therapy after surgery, or as the primary treatment for advanced disease.
Common Symptoms
- Persistent upper abdominal pain or discomfort
- Unexplained weight loss and loss of appetite
- Nausea, vomiting, or early satiety
- Difficulty swallowing
- Blood in stool or dark/tarry stools
- Fatigue and anaemia
Diagnosis & Molecular Profiling
Accurate diagnosis and comprehensive molecular profiling are essential to guide systemic treatment decisions. At Shanghai's leading centers, this includes:
- Gastroscopy with biopsy — definitive diagnosis and histological subtyping
- CT scan (chest/abdomen/pelvis) — staging and treatment response assessment
- HER2 testing — IHC and FISH for targeted therapy eligibility
- PD-L1 expression — CPS score for immunotherapy eligibility
- MSI/MMR status — microsatellite instability testing for immunotherapy response prediction
- FGFR2b, VEGFR2, CLDN18.2 — emerging biomarkers for novel targeted agents
- Next-generation sequencing (NGS) — comprehensive genomic profiling for clinical trial eligibility
Systemic Treatment Options for Gastric Cancer
Chemotherapy
Chemotherapy remains the backbone of gastric cancer systemic treatment. Standard regimens include:
- FLOT (docetaxel, oxaliplatin, leucovorin, 5-FU) — perioperative standard for resectable disease
- SOX / XELOX (oxaliplatin + S-1 or capecitabine) — widely used in Asia
- FOLFOX / FOLFIRI — for advanced/metastatic disease
- Paclitaxel-based regimens — second-line options
Targeted Therapy
- HER2-positive gastric cancer: Trastuzumab (Herceptin) + chemotherapy — first-line standard; trastuzumab deruxtecan (T-DXd) for HER2-positive second-line
- VEGFR2 inhibition: Ramucirumab — second-line for advanced disease
- FGFR2b-positive: Bemarituzumab (emerging first-line option)
- CLDN18.2-positive: Zolbetuximab (emerging targeted agent)
Immunotherapy
- PD-1/PD-L1 inhibitors: Pembrolizumab, Nivolumab — first-line (PD-L1 CPS ≥5) and second-line options
- MSI-H / dMMR tumors: Particularly strong response to immunotherapy; pembrolizumab approved as first-line
- Perioperative immunotherapy: Increasingly integrated with chemotherapy before and after surgery for locally advanced disease
Combination & Emerging Strategies
The most significant recent advances in gastric cancer medical oncology involve combining immunotherapy with chemotherapy and targeted agents. Clinical trials exploring novel combinations — including bispecific antibodies, ADCs (antibody-drug conjugates), and CAR-T cell therapy — are actively enrolling at Shanghai's leading cancer centers.
Why Choose Shanghai for Gastric Cancer Medical Oncology?
- Internationally trained oncologists — many with fellowship experience at leading US and European cancer centers
- Access to novel agents and clinical trials — Shanghai centers participate in major international gastric cancer trials
- Comprehensive molecular profiling — full biomarker workup to guide personalized treatment
- Multidisciplinary tumor boards — every complex case reviewed by surgery, medical oncology, radiation oncology, radiology, and pathology
- Cost-effective world-class care — significantly lower cost than equivalent treatment in the US, UK, or Singapore
Featured Specialist: Prof. Li Qi — Shanghai First People's Hospital
Prof. Li Qi (李琥) is a Chief Physician of Medical Oncology at Shanghai First People's Hospital (Shanghai General Hospital), affiliated with Shanghai Jiao Tong University School of Medicine. She is a former Visiting Scholar at MD Anderson Cancer Center — one of the world's premier cancer institutions — bringing an international perspective and exposure to cutting-edge oncology research to her clinical practice in Shanghai.
Clinical Expertise
- Gastric cancer chemotherapy — perioperative, adjuvant, and palliative chemotherapy regimens
- Targeted therapy — HER2-directed therapy, anti-VEGFR agents, and emerging targeted options
- Immunotherapy — PD-1/PD-L1 inhibitor-based regimens, including combination chemoimmunotherapy
- Comprehensive systemic treatment — individualized, biomarker-driven treatment planning for all stages of gastric cancer
MD Anderson-Trained Perspective
Prof. Li's training at MD Anderson Cancer Center — consistently ranked the world's top cancer hospital — ensures her clinical approach is aligned with international best practices. For international patients seeking oncology care in Shanghai that meets Western standards, Prof. Li offers a uniquely reassuring combination of global training and local expertise.
For international patients, Prof. Li's team offers remote pre-consultation review of medical records, imaging, and molecular profiling reports, enabling a personalized systemic treatment plan to be developed before arrival in Shanghai.
How CMCS Supports Your Journey
CMCS is not a hospital — we are your dedicated medical concierge, providing a trusted bridge between international patients and Shanghai's finest cancer specialists.
Our services include:
- ✅ Direct appointment coordination with Prof. Li Qi and other top gastric cancer medical oncologists
- ✅ Medical record, imaging, and molecular profiling translation and pre-consultation review
- ✅ Second opinion facilitation
- ✅ Treatment scheduling and hospital coordination support
- ✅ Accommodation and logistics coordination in Shanghai
- ✅ Post-treatment follow-up and remote check-in support
Contact CMCS
If you or a loved one has been diagnosed with gastric cancer and would like to explore systemic treatment options in Shanghai, our team is ready to help.
📧 Email: contract@medicalsh.com
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CMCS — China Medical Concierge Shanghai. Connecting international patients with Shanghai's finest specialists.
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