Current status and future perspectives on neoadjuvant therapy in gastric cancer

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Gastric cancer (GC) is a heterogeneous disease with high mortality.
• Standard treatment involves radical gastrectomy and postoperative chemotherapy.
• Neoadjuvant therapy (NAT) shows potential but faces implementation challenges.

Purpose of the Study:

• To review current issues and challenges in neoadjuvant therapy for gastric cancer.
• To discuss optimal patient selection, regimen choice, and assessment methods for NAT in GC.
• To explore the appropriate timing for surgery after NAT for GC.

Main Methods:

• Literature review of neoadjuvant therapy in gastric cancer.
• Analysis of current challenges in NAT implementation, including patient selection and regimen efficacy.
• Discussion of imaging techniques (e.g., enhanced CT) and pathological response assessment.
• Review of factors influencing the NAT-surgery interval.

Main Results:

• Clinical benefits of NAT for GC are observed but require further validation.
• Current methods for evaluating NAT effectiveness (e.g., RECIST via CT) may not perfectly correlate with pathological responses.
• Optimal criteria for patient selection, ideal regimens, and the timing of surgery post-NAT remain areas needing clarification.

Conclusions:

• Neoadjuvant therapy (NAT) for gastric cancer (GC) requires optimization regarding patient selection and treatment regimens.
• Accurate assessment of treatment response and determination of the optimal surgical timing are critical for successful NAT implementation.
• Further clinical trials are needed to establish definitive guidelines for NAT in GC management.