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Updated: Jun 22, 2025
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Progress and prospects of biomarker-based targeted therapy and immune checkpoint inhibitors in advanced gastric
1Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, China.
Abstract:
Gastric cancer and gastroesophageal junction cancer represent the leading cause of tumor-related death worldwide. Although advances in immunotherapy and molecular targeted therapy have expanded treatment options, they have not significantly altered the prognosis for patients with unresectable or metastatic gastric cancer. A minority of patients, particularly those with PD-L1-positive, HER-2-positive, or MSI-high tumors, may benefit more from immune checkpoint inhibitors and/or HER-2-directed therapies in advanced stages. However, for those lacking specific targets and unique molecular features, conventional chemotherapy remains the only recommended effective and durable regimen. In this review, we summarize the roles of various signaling pathways and further investigate the available targets. Then, the current results of phase II/III clinical trials in advanced gastric cancer, along with the superiorities and limitations of the existing biomarkers, are specifically discussed. Finally, we will offer our insights in precision treatment pattern when encountering the substantial challenges.
Insights
Advanced gastric cancer treatments remain challenging, with limited options beyond chemotherapy for many patients. This review explores targeted therapies and biomarkers, offering insights into precision medicine for unresectable or metastatic disease.
Area of Science:
- Oncology
- Gastroenterology
- Molecular Biology
Background:
- Gastric cancer and gastroesophageal junction cancer are leading global causes of cancer death.
- Current treatments, including immunotherapy and targeted therapy, offer limited improvement for unresectable or metastatic disease.
- A subset of patients may benefit from specific therapies based on PD-L1, HER-2, or MSI status.
Purpose of the Study:
- To review signaling pathways and therapeutic targets in advanced gastric cancer.
- To discuss current clinical trial outcomes for advanced gastric cancer.
- To analyze the efficacy and limitations of existing biomarkers in precision treatment.
Main Methods:
- Comprehensive literature review of signaling pathways and therapeutic targets.
- Analysis of phase II/III clinical trial data in advanced gastric cancer.
- Evaluation of biomarker utility and limitations in treatment selection.
Main Results:
- Specific molecular targets (PD-L1, HER-2, MSI-high) identify patient subgroups for immunotherapy and HER-2-directed therapies.
- Conventional chemotherapy remains the primary option for patients lacking identified molecular targets.
- Existing biomarkers show promise but have limitations in guiding treatment decisions.
Conclusions:
- Precision treatment strategies are crucial for improving outcomes in advanced gastric cancer.
- Further research is needed to overcome challenges and refine biomarker-driven therapeutic approaches.
- Integrating molecular profiling into treatment algorithms is essential for personalized care.
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