Jacobs Journal of Cancer Science and Research

Immunotherapy and Gastric Cancer

Published on: 2018-11-22

Abstract

Gastric Cancer (GC) is the fourth common cancer worldwide though it has a low incidence in the United States (US). It has a geographical distribution affecting mainly the underprivileged developing countries much more than the affluent developed ones. It is an aggressive disease with high mortality rate. Modest breakthroughs in the treatment of GC occurred in the last couple of decades and it was restricted to chemotherapy and surgical techniques. The development of gastric cancer is a complex, multistep process, which involves multiple genetic and epigenetic alterations. The previous classifications of GC had limited impact on its management and prognosis. A newer molecular classification will help us understand the cancer of the stomach better. It will pave the way for an individualized directed therapy which will allow more robust targeted therapeutic options with better prognosis. According to The Cancer Genome Atlas Project (TCGA), GC has been recently divided into 4 categories according to the molecular imprint specification. These 4 subtypes are Epstein-Barr virus positive tumors (EBVp), microsatellite instability tumors (MSI), genomically stable tumors (GS) and tumors with chromosomal instability (CIN). Immunotherapy is a very promising treatment modality where it is designed to improve or restore the patient’s immune system to fight cancer. There is an immense diversity in the pathways where immunotherapeutic agents could target, many will fall under the TCGA classification, and similarly many will lie outside. We review here all the available immunotherapies Food and Drug administration approved and currently under evaluation in multiple clinical trials for the treatment of GC.

Keywords

Gastric cancer; Immunotherapy; Monoclonal antibodies; Check point inhibitors; Cytokines