Immunotherapy for advanced gastric cancer

Abstract

Gastric cancer (GC) is believed to be the fifth most common cancer and the third most common cause of death worldwide. Treatment techniques include radiation, chemotherapy, gastrectomy, and targeted treatments are often employed. Some hopeful results from the development of GC immunotherapy have already changed treatment approaches. Along with previous combination medicines, new immunotherapies have been developed that target distinct molecules. Despite ongoing studies into the current therapeutic options and significant improvements in this field, the prognosis for the ailment is poor. Since there are few treatment options and a delay in detection, the illness actually advances, spreads, and metastasizes. The bulk of immunotherapies in use today rely on cytotoxic immune cells, monoclonal antibodies, and gene-transferred vaccines. Immune checkpoint inhibitors have become more popular. In this review, we sought to examine the viewpoint and development of several immunotherapy treatment modalities for advanced GC, as well as the clinical results thus far reported. Additionally, we outlined tumor immune escape and tumor immunosurveillance.

Keywords: Advanced gastric cancer; Biomarkers; Cancer vaccine; Chemotherapy; Immunotherapy; Personalized medicine.

Figure 1

The molecular findings in gastric cancer by The Cancer Genome Atlas compared with the Asian Cancer Research Group. TCGA: The Cancer Genome Atlas; ACRG: Asian Cancer Research Group; EGFR: Epithelial growth factor receptor; CIN: Chromosomal instability; HER: Human epidermal growth factor receptor; FGFR2: Fibroblast growth factor receptor 2; MSI: Microsatellite instability; GS: Genomically stable; EBV: Epstein-Barr virus; PD-L1/2: Programmed death ligand-1/2; RTKs: Receptor tyrosine kinases; RAS: Rat sarcoma virus; ERBB2/3: Erb-b2 receptor tyrosine kinase 2/3; JAK2: Janus-associated kinase 2; MLH1: MutL protein homolog 1; MSH: Melanocyte-stimulating hormones; CDKN2A: Cyclin-dependent kinase inhibitor 2A; PI3K: Phosphatidylinositol-3-kinase; ARID1A: AT-rich interactive domain-containing protein 1A; BCOR: B-cell lymphoma 6 corepressor; MSS: Microsatellite stable; TP53: tumor protein 53; MYC: Myelocytomatosis oncogene; GATA6: GATA binding protein 6; MMR: Measles-mumps-rubella; CDH1: Cadherin 1; EMT: Epithelial-mesenchymal transition; E-CAD: E-cadherin; ALK: Anaplastic lymphoma kinase.

Figure 2

Immune check point inhibitors for advanced gastric cancer treatment. CTLA4: Cytotoxic T-lymphocyte-associated protein 4; TCR: T-cell receptor; PD-1: Programmed cell death protein 1; PD-L1: Programmed cell death ligand-1; MCH: Melanin-concentrating hormone.