Treatment of gastric adenocarcinoma: A rapidly evolving landscape

Eur J Cancer. 2023 Dec:195:113370. doi: 10.1016/j.ejca.2023.113370. Epub 2023 Oct 17.

Abstract

Gastric adenocarcinoma (GC) and gastroesophageal junction adenocarcinoma represent frequent and severe diseases whose management has radically changed over the last 10 years. With the advent of second- and third-line standard therapies for metastatic GC patients in the 2010s, the molecular dismemberment of the disease and positive trials with immunotherapy and targeted agents will mark the 2020s. New treatment options have emerged in the neoadjuvant, adjuvant, and metastatic setting. In addition to improved multimodal treatment in operable patients, new subgroups have emerged depending on molecular alterations (HER2, Microsatellite instability) or expression of specific proteins in the tumour (PDL1, Claudin 18.2) making immunohistochemistry central in profiling the tumour for an optimal individualised management. The aim of this review is to describe the current standards of management of early and late stage GC and the molecular markers needed today to optimally manage our patients together with future perspectives on this disease.

Keywords: Claudin 18.2; Fibroblast growth factor receptor 2; Gastric adenocarcinoma; Gastroesophageal junction adenocarcinoma; HER-2; Immunotherapy; Microsatellite instability.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma* / drug therapy
  • Antineoplastic Agents* / therapeutic use
  • Combined Modality Therapy
  • Esophageal Neoplasms* / pathology
  • Esophagogastric Junction / pathology
  • Humans
  • Stomach Neoplasms* / drug therapy
  • Stomach Neoplasms* / metabolism

Substances

  • Antineoplastic Agents