The latest clinical trials of stomach cancer treatment

According to the statistics of the World Health Organization (WHO), stomach (gastric)cancer, one of the most common malignancies worldwide, ranks among the top five causes of cancer-related mortality. Late-stage diagnosis due to limited screening options and the absence of early-stage symptoms, the aggressive nature and biological diversity, are the major treatment challenges that reduce survival and recovery rates. Recent developments in immunotherapy and targeted therapy have changed the treatment landscape for advanced gastric cancer." Methods: This review examines recent studies on gastric cancer treatment, focusing on articles published in Google Scholar between ۲۰۲۱ and ۲۰۲۴, using keywords such as "gastric cancer," "molecular targets," "immunotherapy," and "clinical trials." Results: As a result of the ToGA study, Trastuzumab has improved overall survival (OS) in patients with metastatic gastric cancer by inhibiting the human epidermal growth factor receptor ۲ (HER۲). Furthermore, the combination of this biological agent with chemotherapy is considered a standard first-line treatment for metastatic gastric cancer patients. Among the monoclonal antibodies (mAbs) used in targeted therapy, Ramucirumab by binding to vascular endothelial growth factor (VEGF), has become the first targeted therapy for angiogenesis in patients with advanced gastric cancer (REGARD trial). Immune checkpoint inhibitors, as a key therapeutic strategy in immunotherapy, have prolonged survival by blocking immune checkpoints. Nivolumab combined with chemotherapy demonstrated overall survival (OS) in HER۲-negative patients with a PD-L۱ combined positive score (CPS) of ≥ ۵ (Checkmate ۶۴۹ trial). According to the Keynote-۱۵۸ trial, Pembrolizumab monotherapy demonstrated high activity in previously treated patients with microsatellite instability-high gastric (MSI-H) cancer. Also, chimeric antigen receptors (CAR)-T cells, as a novel immunotherapy strategy, have been used with some initial success in advanced gastric cancer. Conclusion: This review examines recent developments in gastric cancer that have prolonged survival and increased effectiveness. These findings highlight the shift in treatment strategies towards targeting molecular pathways and utilizing combination therapies. However, further research is necessary to overcome the challenges of gastric cancer treatment and benefit a wider range of patients.

کلیدواژه ها:

gastric cancer ، molecular targets ، immunotherapy ، clinical trials