Updated Immunotherapy for Gastric Cancer

Gastric cancer treatments are evolving rapidly. For example, immune checkpoint inhibitors, especially those that target PD-1 or PD-L1, have long-term efficacy in a subset of gastric cancer patients, and are currently the first-line therapy. Immunotherapies approved for use in untreated gastric cancer patients include monotherapy and chemotherapy-immunotherapy combinations. Major clinical trials have reported efficacy and safety data suggesting that PD-L1 expression is important for regimen selection, although other biomarkers, clinicopathologic factors, and patient preference might also be relevant in other situations. Currently, several novel biomarkers and therapeutic strategies are being assessed, which might refine the current treatment paradigm. In this review, we describe the current treatment regimens for patients with gastric cancer and detail the approach we use for the selection of first-line immunotherapy regimens.

Automated summary

Gastric cancer treatments are rapidly evolving, with immune checkpoint inhibitors targeting PD-1 or PD-L1 showing long-term efficacy in some patients and currently being the first-line therapy. Approved immunotherapies for untreated gastric cancer patients include monotherapy and chemotherapy-immunotherapy combinations. Clinical trials have indicated the importance of PD-L1 expression in regimen selection, although other biomarkers, clinicopathologic factors, and patient preference might also be relevant. Novel biomarkers and therapeutic strategies are currently being assessed, potentially refining the current treatment paradigm. This review describes current treatment regimens for gastric cancer patients and details our approach to selecting first-line immunotherapy regimens.