How to Best Exploit Immunotherapeutics in Advanced Gastric Cancer: Between Biomarkers and Novel Cell-Based Approaches

Despite extensive research efforts, advanced gastric cancer still has a dismal prognosis with conventional treatment options. Immune checkpoint inhibitors have revolutionized the landscape for many solid tumors. Amongst subtypes, tumors microsatellite instability and Epstein Barr Virus positive provide strongest rationale responding to immunotherapy. Various predictive biomarkers such as mismatch repair status, programmed death ligand 1 expression, tumor mutational burden, assessment of infiltrating lymphocytes circulating been evaluated. However, results inconsistent due different methodologies thresholds used. Clinical implementation therefore remains challenge. The role immune in is emerging data from monotherapy heavily pre-treated population already available studies earlier disease settings combinatorial approaches progress. inhibitor combinations chemotherapy (CT), anti-angiogenics, tyrosine kinase inhibitors, anti-Her2 directed therapy, poly (ADP-ribose) polymerase or dual strategies are being explored. Moreover, novel including vaccines CAR T cell therapy also trialed. Here we an update on response immunotherapy overview their strengths limitations. We discuss clinical trials that reported progress whilst providing account future steps needed improve outcome this lethal disease.