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Immune checkpoint inhibitor therapy for gastric cancer: current status, therapeutic challenges, and future prospects
Penghui Liu1, Na Li1, Jiwu Guo1
1Lanzhou University Second Hospital, The General Surgery Department, Lanzhou, China.
Abstract:
Gastric cancer is among the most prevalent malignant tumors of the digestive system worldwide. In recent years, immune checkpoint inhibitors (ICIs) have achieved substantial advances in the treatment of gastric cancer. By blocking the PD-1/PD-L1 and CTLA-4 signaling pathways, ICIs enhance antitumor immune responses and offer novel therapeutic options for patients. However, their clinical application continues to face significant challenges, including therapeutic resistance, immune-related adverse events, the lack of reliable biomarkers, and an immunosuppressive tumor microenvironment. This narrative review summarizes recent advances in ICIs-based therapies for gastric cancer, provides an in-depth analysis of existing clinical challenges, and highlights key future research directions, including biomarker discovery, development of predictive models, optimization of combination regimens, targeting of resistance mechanisms, modulation of the tumor-associated microbiota, and improved toxicity management. Moving forward, efforts should focus on advancing immunotherapy toward individualized and precision-based approaches to maximize both efficacy and safety, thereby enabling further optimization and breakthroughs in gastric cancer immunotherapy.
Insights
Immune checkpoint inhibitors (ICIs) show promise for gastric cancer treatment by boosting immune responses. However, challenges like resistance and side effects necessitate further research for personalized immunotherapy strategies.
Area of Science:
- Oncology
- Immunology
- Gastroenterology
Background:
- Gastric cancer is a leading digestive system malignancy globally.
- Immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 and CTLA-4 pathways have advanced gastric cancer treatment.
- Despite progress, significant challenges impede ICI efficacy in gastric cancer.
Purpose of the Study:
- To review recent advances in ICI-based gastric cancer therapies.
- To analyze current clinical challenges associated with ICIs.
- To highlight future research directions for optimizing gastric cancer immunotherapy.
Main Methods:
- Narrative review of current literature on ICIs in gastric cancer.
- Analysis of therapeutic resistance, adverse events, biomarkers, and tumor microenvironment.
- Identification of key areas for future research and development.
Main Results:
- ICIs offer novel therapeutic options by enhancing antitumor immunity.
- Key challenges include therapeutic resistance, immune-related adverse events, lack of biomarkers, and immunosuppressive tumor microenvironment.
- Future directions involve biomarker discovery, predictive models, combination regimens, resistance targeting, microbiota modulation, and toxicity management.
Conclusions:
- Advancing gastric cancer immunotherapy requires addressing current challenges.
- Future efforts should focus on individualized, precision-based approaches for maximum efficacy and safety.
- Optimizing ICI therapy holds potential for significant breakthroughs in gastric cancer treatment.
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