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Navigating the crossroads in gastric cancer therapy: New horizons and unresolved challenges

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  • Corresponding author: shenlin@bjmu.edu.cn
  • Treatment of gastric cancer is rapidly evolving from conventional chemotherapy toward biomarker-guided care. In perioperative and metastatic settings, immunotherapy and treatments targeting HER2 and claudin 18.2 (CLDN18.2) have expanded therapeutic options, while antibody-drug conjugates, bispecific antibodies, and cellular therapies are reshaping later-line management. These advances also create challenges in patient selection, toxicity management, and treatment sequencing, particularly when biomarkers overlap or change during therapy. This perspective summarizes recent progress across the disease course and discusses the major unresolved questions in optimizing treatment strategies for gastric cancer.
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  • [1] Janjigian Y.Y., Al-Batran S.-E., Wainberg Z.A., et al. (2025). Perioperative durvalumab in gastric and gastroesophageal junction cancer. N. Engl. J. Med. 393:217−230. DOI:10.1056/NEJMoa2503701

    View in Article CrossRef Google Scholar

    [2] Shen L., Zhang X., Ji K., et al. (2026). Perioperative serplulimab with neoadjuvant chemotherapy versus perioperative chemotherapy in PD-L1-positive gastric cancer (ASTRUM-006): A randomised, double-blind, multicentre, phase 3 study. Lancet 407:2542−2553. DOI:10.1016/S0140-6736(26)00974-8

    View in Article CrossRef Google Scholar

    [3] Janjigian Y.Y., Kawazoe A., Bai Y., et al. (2023). Pembrolizumab plus trastuzumab and chemotherapy for HER2-positive gastric or gastro-oesophageal junction adenocarcinoma: Interim analyses from the phase 3 KEYNOTE-811 randomised placebo-controlled trial. Lancet 402:2197−2208. DOI:10.1016/S0140-6736(23)02033-0

    View in Article CrossRef Google Scholar

    [4] Teran E., Pazo R., Carita L., et al. (2026). Claudin 18.2 expression in gastroesophageal adenocarcinoma: biomarker overlap and association with clinical outcomes in a European cohort. ESMO Open 11:106053. DOI:10.1016/j.esmoop.2025.106053.

    View in Article Google Scholar

    [5] Shitara K., Lordick F., Bang Y.-J., et al. (2023). Zolbetuximab plus mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative, untreated, locally advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (SPOTLIGHT): A multicentre, randomised, double-blind, phase 3 trial. Lancet 401:1655–1668. DOI:10.1016/S0140-6736(23)00620-7.

    View in Article Google Scholar

    [6] Rha S.Y., Oh D.-Y., Yanez P., et al. (2023). Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for HER2-negative advanced gastric cancer (KEYNOTE-859): A multicentre, randomised, double-blind, phase 3 trial. Lancet Oncol. 24:1181−1195. DOI:10.1016/S1470-2045(23)00515-6

    View in Article CrossRef Google Scholar

    [7] Shitara K., Van Cutsem E., Gumus M., et al. (2025). Trastuzumab deruxtecan or ramucirumab plus paclitaxel in gastric cancer. N. Engl. J. Med. 393:336−348. DOI:10.1056/NEJMoa2503119

    View in Article CrossRef Google Scholar

    [8] Qi C., Liu C., Peng Z., et al. (2025). Claudin-18 isoform 2-specific CAR T-cell therapy (satri-cel) versus treatment of physician's choice for previously treated advanced gastric or gastro-oesophageal junction cancer (CT041-ST-01): A randomised, open-label, phase 2 trial. Lancet 405:2049−2060. DOI:10.1016/S0140-6736(25)00860-8

    View in Article CrossRef Google Scholar

    [9] Jia K., Chen Y., Dai D., et al. (2026). Impact of Helicobacter pylori infection on gut and intratumoral microbiome and its association with immunotherapy response in gastrointestinal cancer. BMC Med. 24:79. DOI:10.1186/s12916-025-04575-0

    View in Article CrossRef Google Scholar

    [10] Jia K., Chen Y., Xie Y., et al. (2023). Multidimensional immune profiling in Gastric Cancer Multiplex Immunohistochemistry Atlas from Peking University Cancer Hospital project informs PD-1/PD-L1 blockade efficacy. Eur. J. Cancer 189:112931. DOI:10.1016/j.ejca.2023.05.019

    View in Article CrossRef Google Scholar

  • Cite this article:

    Jin Z., Jiao X., Xie T., et al. (2026). Navigating the crossroads in gastric cancer therapy: New horizons and unresolved challenges. The Innovation Oncology 1:100024. https://doi.org/10.59717/j.xinn-oncol.2026.100024
    Jin Z., Jiao X., Xie T., et al. (2026). Navigating the crossroads in gastric cancer therapy: New horizons and unresolved challenges. The Innovation Oncology 1:100024. https://doi.org/10.59717/j.xinn-oncol.2026.100024

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