The Present and Future of Neoadjuvant and Adjuvant Therapy for Locally Advanced Gastric Cancer

• Published in: Cancers Vol. 15; no. 16; p. 4114
• Main Authors: Koerner, Anna S, Moy, Ryan H, Ryeom, Sandra W, Yoon, Sam S
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.08.2023; MDPI
• Subjects: Adjuvant therapy; Adjuvant treatment; Biomarkers; Cancer; Cancer therapies; Chemotherapy; Clinical trials; Epstein-Barr virus; ErbB-2 protein; Fibroblast growth factor receptor 2; Gastric cancer; Gastroesophageal reflux; Gastrointestinal surgery; Gene amplification; Health aspects; Immunotherapy; Kinases; locally advanced; Lymphatic system; Medical prognosis; Metastases; Metastasis; Microsatellite instability; neoadjuvant therapy; Patients; PD-L1 protein; Review; Stomach cancer; targeted therapy; Tumors; South Korea; Japan; targeted therapy; gastric cancer; biomarkers; immunotherapy; adjuvant therapy; locally advanced; neoadjuvant therapy
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers15164114

Gastric cancer is a highly prevalent and lethal disease worldwide. Given the insidious nature of the presenting symptoms, patients are frequently diagnosed with advanced, unresectable disease. However, many patients will present with locally advanced gastric cancer (LAGC), which is often defined as the primary tumor extending beyond the muscularis propria (cT3-T4) or having nodal metastases (cN+) disease and without distant metastases (cM0). LAGC is typically treated with surgical resection and perioperative chemotherapy. The treatment of LAGC remains a challenge, given the heterogeneity of this disease, and the optimal multimodal treatment regimen may be different for different LAGC subtypes. However, many promising treatments are on the horizon based on knowledge of molecular subtypes and key biomarkers of LAGC, such as microsatellite instability, HER2, Claudin 18.2, FGFR2, and PD-L1. This review will expand upon the discussion of current standard neoadjuvant and adjuvant therapies for LAGC and explore the ongoing and future clinical trials for novel therapies, with information obtained from searches in PubMed and ClinicalTrials.gov.