Gastric cancer: a comprehensive review of current and future treatment strategies

Cancer Metastasis Rev. 2020 Dec;39(4):1179-1203. doi: 10.1007/s10555-020-09925-3. Epub 2020 Sep 7.


Gastric cancer remains a major unmet clinical problem with over 1 million new cases worldwide. It is the fourth most commonly occurring cancer in men and the seventh most commonly occurring cancer in women. A major fraction of gastric cancer has been linked to variety of pathogenic infections including but not limited to Helicobacter pylori (H. pylori) or Epstein Barr virus (EBV). Strategies are being pursued to prevent gastric cancer development such as H. pylori eradication, which has helped to prevent significant proportion of gastric cancer. Today, treatments have helped to manage this disease and the 5-year survival for stage IA and IB tumors treated with surgery are between 60 and 80%. However, patients with stage III tumors undergoing surgery have a dismal 5-year survival rate between 18 and 50% depending on the dataset. These figures indicate the need for more effective molecularly driven treatment strategies. This review discusses the molecular profile of gastric tumors, the success, and challenges with available therapeutic targets along with newer biomarkers and emerging targets.

Keywords: Autophagy; Gastric adenocarcinoma; Gastric cancer; Non coding RNAs; Novel targets; Piwi RNA; lncRNA.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Biomarkers, Tumor / metabolism
  • Clinical Trials, Phase II as Topic
  • Clinical Trials, Phase III as Topic
  • Combined Modality Therapy
  • Epstein-Barr Virus Infections / pathology
  • Helicobacter Infections / pathology
  • Helicobacter pylori / isolation & purification
  • Herpesvirus 4, Human / isolation & purification
  • Humans
  • Molecular Targeted Therapy
  • Neoplasm Staging
  • Randomized Controlled Trials as Topic
  • Stomach Neoplasms / metabolism
  • Stomach Neoplasms / microbiology
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / therapy*


  • Biomarkers, Tumor