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Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT

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Gastric Cancer: A Review.

Anuj Kishor Patel¹, Nilay S Sethi¹, Haeseong Park¹

¹Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.

|January 7, 2026

Summary

Gastric cancer, a leading cause of cancer death, is often diagnosed at advanced stages. New treatments combining chemotherapy, immunotherapy, and targeted therapies show improved survival for advanced gastric cancer.

Area of Science:

Oncology
Gastroenterology

Background:

Gastric cancer is a significant global health concern, with millions of new cases and hundreds of thousands of deaths reported annually.
The majority of gastric cancers are adenocarcinomas, predominantly affecting the stomach body or antrum, and are more common in men, with a median age at diagnosis of 68 years.

Purpose of the Study:

To summarize the current understanding of gastric cancer epidemiology, risk factors, diagnosis, and treatment strategies.
To highlight advancements in treatment for advanced or metastatic gastric cancer, including the role of immunotherapy and targeted therapies.

Main Methods:

Review of epidemiological data on gastric cancer incidence and mortality.
Analysis of diagnostic methods, including endoscopic biopsy.
Evaluation of treatment outcomes for localized, locally advanced, and metastatic gastric cancer based on current clinical practices and emerging therapies.

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Main Results:

Gastric cancer diagnosis often occurs at advanced stages (locally advanced or metastatic) in the US, with less than 10% of metastatic cases surviving beyond 5 years.
Helicobacter pylori infection, smoking, alcohol, obesity, and salt intake are key modifiable risk factors.
Localized gastric cancer treated with surgery has a 5-year survival rate of 75%.
Advanced gastric cancer treatments involving perioperative chemotherapy, immunotherapy (e.g., durvalumab), and targeted therapies (e.g., trastuzumab for ERBB2-overexpressing cancers, zolbetuximab for CLDN18.2-overexpressing cancers) improve survival by several months.

Conclusions:

Early diagnosis through screening in high-incidence countries improves survival.
Multimodal treatment approaches, including surgery, chemotherapy, immunotherapy, and targeted therapy, are crucial for managing gastric cancer at different stages.
Emerging targeted therapies and immunotherapies offer survival benefits for patients with advanced or unresectable gastric cancer, particularly when guided by specific biomarkers.