Targeted therapies in metastatic gastric cancer: Current knowledge and future perspectives

World J Gastroenterol. 2019 Oct 14;25(38):5773-5788. doi: 10.3748/wjg.v25.i38.5773.


Gastric cancer (GC) represents a leading cause of cancer related morbidity and mortality worldwide accounting for more than 1 million of newly diagnosed cases and thousands of deaths every year. In the last decade, the development of targeted therapies and the optimization of already available chemotherapeutic drugs has expanded the available treatment options for advanced GC and granted better survival expectations to the patients. At the same time, global efforts have been undertaken to investigate in detail the genomic and epigenomic heterogeneity of this disease, resulting in the identification of new specific and sensitive predictive and prognostic biomarkers and in innovative molecular classifications based on gene expression profiling. Nonetheless, several randomized studies aimed at exploring new innovative agents, such as immune checkpoint inhibitors, failed to demonstrate clinically meaningful survival advantages. Therefore, it is essential to further improve the molecular characterization of GC subgroups in order to provide researchers and medical oncologists with new tools for patients' selection and stratification in future clinical development programs and subsequent trials. The aim of the present manuscript is to provide a global overview of the recent molecular classifications from The Cancer Genome Atlas and the Asian Cancer Research Group and to present key promising developments in the field of immunotherapy and targeted therapies in metastatic GC.

Keywords: Asian Cancer Research Group; Gastric cancer; Molecular diagnostic; Personalized medicine; Predictive biomarkers; The Cancer Genome Atlas.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / genetics
  • Adenocarcinoma / mortality
  • Adenocarcinoma / secondary
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / antagonists & inhibitors
  • Biomarkers, Tumor / genetics
  • Costimulatory and Inhibitory T-Cell Receptors / antagonists & inhibitors
  • Humans
  • Immunotherapy / methods*
  • Immunotherapy / trends
  • Molecular Targeted Therapy / methods*
  • Molecular Targeted Therapy / trends
  • Patient Selection
  • Precision Medicine / methods*
  • Precision Medicine / trends
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Treatment Outcome


  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Costimulatory and Inhibitory T-Cell Receptors