OnCo
cancersCancer

Gastric & gastro-oesophageal junction cancer

A cancer with three new targets in five years: Claudin 18.2, FGFR2b, and HER2 with new ADCs, plus immunotherapy in first line.

Gastric and gastro-oesophageal junction adenocarcinoma causes about one million new cases and 660,000 deaths a year, concentrated in East Asia, Eastern Europe, and Latin America, where Helicobacter pylori infection, salt, and smoking drive incidence. Japan and Korea screen endoscopically and cure most cases early; elsewhere two-thirds present with advanced disease and five-year survival is under 30%. Biology splits by the Lauren classification (intestinal vs diffuse) and the TCGA classes (EBV-positive, MSI, genomically stable, chromosomally unstable), and clinically by three actionable biomarkers: HER2 (~15-20%), PD-L1 (CPS ≥5 in ~60%), and Claudin 18.2 (~38% at the approval threshold), with FGFR2b, MSI, and EBV as further strata.

Localised disease is treated with gastrectomy and D2 lymphadenectomy plus perioperative chemotherapy: FLOT in the West, adjuvant S-1 or CAPOX in Asia. MATTERHORN (2025) added durvalumab to FLOT, the first perioperative immunotherapy with an overall survival benefit (3-year OS 68.6%). Advanced disease is stratified at diagnosis: HER2-positive tumours get trastuzumab + chemotherapy + pembrolizumab (KEYNOTE-811) or, after HERIZON-GEA-01, zanidatamab + chemotherapy ± tislelizumab; HER2-negative, PD-L1 CPS ≥5 tumours get nivolumab or pembrolizumab with chemotherapy (CheckMate 649 5-year OS 16% vs 6%); CLDN18.2-positive tumours get zolbetuximab + chemotherapy (SPOTLIGHT/GLOW). Second line: T-DXd for HER2-positive disease (DESTINY-Gastric04, OS 14.7 vs 11.4 months), ramucirumab + paclitaxel otherwise, and from 2026 the CLDN18.2 ADC sonesitatug vedotin (CLARITY-Gastric 01). Third line: trifluridine/tipiracil.

The frontier is Claudin 18.2 (ADCs, CAR-T satri-cel approved in China, bispecifics), biomarker overlap and combination quadruplets, peritoneal-directed therapy for the commonest site of relapse, FGFR2b after the mixed FORTITUDE-101 result, and ctDNA-guided perioperative strategies. Diffuse-type and genomically stable tumours remain the least treatable subgroup.

State of the art today

  • Biomarker-stratified first line with four possible add-ons.
  • First solid-tumour CAR-T approval (China).
  • Three first-line biomarkers (HER2, PD-L1, CLDN18.2) each with a phase 3-proven add-on to chemotherapy; testing all three at diagnosis is standard.
  • Zanidatamab beat trastuzumab head-to-head first line (HERIZON-GEA-01, 2026), the first HER2 advance in first line since ToGA.
  • T-DXd has phase 3 proof in second-line HER2-positive disease (DESTINY-Gastric04).
  • Claudin 18.2 is the first target with an antibody, an ADC with OS benefit (CLARITY-Gastric 01, 2026), and an approved CAR-T (satri-cel, China).
Show survival figures (2)

Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • Perioperative durvalumab + FLOT (MATTERHORN) is the first immunotherapy to improve survival in resectable gastric cancer (FDA November 2025).
  • Five-year survivors exist with chemo-immunotherapy in PD-L1-rich disease (16% vs 6%, CheckMate 649).
Who it affects
Show survival figures (1)

Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • ~1 million cases and ~660,000 deaths per year; fifth most common cancer and fifth leading cause of cancer death; 5-year survival >60% in Korea and Japan (screening) vs <30% in most of the West.

Where the cases are

Cases by country · GLOBOCAN 2022
All countries →

Site: Stomach. World: 968,784 new cases, 660,175 deaths.

#CountryNew casesDeaths
1China358,672260,372
2Japan126,72443,807
3India64,61157,727
4Russian Federation38,88327,306
5Korea, Republic of29,2678,517
6United States of America25,55410,976
7Brazil23,02118,138
8Iran, Islamic Republic of17,19113,845
9Viet Nam16,27713,264
10Germany14,0888,729

Standard of care

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Localised

Perioperative FLOT ± durvalumab; D2 gastrectomy.

NCCN Guidelines: Gastric Cancer
DurvalumabRobotic & minimally invasive surgery
Advanced first line

Chemotherapy + PD-1 ± trastuzumab ± zolbetuximab by biomarker.

NCCN Guidelines: Gastric Cancer
NivolumabPembrolizumabTrastuzumab
Later lines

T-DXd (HER2+), zanidatamab, CLDN18.2 CAR-T/ADC in trials.

ESMO-MCBS · 2 (DESTINY-Gastric01 trastuzumab deruxtecan)
Trastuzumab deruxtecanZanidatamabSatricabtagene autoleucelSonesitatug vedotin
Prevention and screening

H. pylori eradication reduces incidence; endoscopic screening programmes in Japan and Korea (biennial from age 40-50) detect most cancers at a curable stage. No population screening in the West. Prophylactic total gastrectomy for germline CDH1 carriers.

Chemoprevention & risk-reducing surgeryGermline (hereditary) testing
Early (T1a) disease

Endoscopic submucosal dissection for well-differentiated mucosal tumours ≤2 cm without ulceration (expanded criteria in Japan); otherwise gastrectomy.

Endoscopic resection (EMR / ESD)
Resectable stage II-III (Western)

Perioperative FLOT + durvalumab (MATTERHORN: OS HR 0.78, pCR 19%) with D2 gastrectomy; FOLFOX/CAPOX perioperatively for patients unfit for docetaxel.

NCCN · Category 1 (perioperative FLOT)
MATTERHORNFLOT (5-FU, leucovorin, oxaliplatin, docetaxel)DurvalumabCAPOX (capecitabine, oxaliplatin)
Resectable stage II-III (Asian practice)

D2 gastrectomy then adjuvant S-1 (ACTS-GC) or CAPOX (CLASSIC) for 6-12 months; neoadjuvant approaches increasingly adopted.

CAPOX (capecitabine, oxaliplatin)
Advanced, HER2-positive, first line

Trastuzumab + fluoropyrimidine/platinum + pembrolizumab (KEYNOTE-811, PD-L1 CPS ≥1); zanidatamab + chemotherapy ± tislelizumab after HERIZON-GEA-01 (PFS 12.4 vs 8.1 months; sBLA 2026).

NCCN · Category 1 (trastuzumab + chemo ± pembroliz…
ToGAHERIZON-GEA-01TrastuzumabZanidatamabPembrolizumabTislelizumabHER2 sequence in gastric cancer: zanidatamab/trastuzumab + chemo ± PD-1 → T-DXd
Advanced, HER2-negative, PD-L1 CPS ≥5 (or ≥1), first line

Nivolumab (CheckMate 649) or pembrolizumab (KEYNOTE-859) or tislelizumab (RATIONALE-305) with FOLFOX or CAPOX; add zolbetuximab if CLDN18.2-positive (sequencing/combination under study).

NCCN · Category 1 (CPS ≥5)ESMO-MCBS · 3 (nivolumab, CPS ≥5)
CheckMate 649KEYNOTE-859NivolumabPembrolizumabTislelizumabFOLFOX (5-FU, leucovorin, oxaliplatin)CAPOX (capecitabine, oxaliplatin)
Advanced, CLDN18.2-positive (≥75%), HER2-negative, first line

Zolbetuximab + mFOLFOX6 or CAPOX (SPOTLIGHT/GLOW). PD-L1 CPS ≥5 double-positives: either add-on; combination trials ongoing.

NCCN · Category 1
SPOTLIGHT & GLOWZolbetuximabFOLFOX (5-FU, leucovorin, oxaliplatin)CAPOX (capecitabine, oxaliplatin)Biomarker-directed first-line quadruplets in gastric cancer
Advanced, HER2-negative, PD-L1 CPS <1 and CLDN18.2-negative

FOLFOX or CAPOX chemotherapy alone; MSI-high tumours get PD-1 blockade regardless of CPS.

FOLFOX (5-FU, leucovorin, oxaliplatin)CAPOX (capecitabine, oxaliplatin)Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)
Second line, HER2-positive

Trastuzumab deruxtecan 6.4 mg/kg (DESTINY-Gastric04, OS 14.7 vs 11.4 months) if HER2 persists on re-biopsy or ctDNA.

NCCN · Category 1
DESTINY-Gastric04Trastuzumab deruxtecan
Second line, HER2-negative

Ramucirumab + paclitaxel (RAINBOW, OS 9.6 vs 7.4 months); CLDN18.2-positive: sonesitatug vedotin after CLARITY-Gastric 01 (2026) or satri-cel CAR-T (China).

NCCN · Category 1 (ramucirumab + paclitaxel)
RAINBOWRamucirumabPaclitaxel / nab-paclitaxelCLARITY-Gastric 01Sonesitatug vedotinSatricabtagene autoleucelCLDN18.2 antibody first line → CLDN18.2 ADC or CAR-T on progression
Third line and beyond

Trifluridine/tipiracil (TAGS, OS 5.7 vs 3.6 months); irinotecan; clinical trials (FGFR2b, CLDN18.2 bispecifics, T-cell engagers).

Trifluridine/tipiracil
Peritoneal metastases

Systemic therapy; intraperitoneal paclitaxel, HIPEC, and PIPAC in trials; palliative gastrectomy not recommended (REGATTA).

Peritoneal metastasisHIPEC / PIPAC (intraperitoneal chemotherapy)Peritoneal-directed therapy for gastric cancer

Subtypes & biomarkers

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Subtypes
  • Intestinal type (Lauren; H. pylori-associated, HER2-enriched)
  • Diffuse / signet-ring type (CDH1, peritoneal spread, poor prognosis)
  • TCGA : EBV-positive (~9%, PD-L1 high, IO-responsive)
  • TCGA : MSI-high (~20% localised, ~5% advanced)
  • TCGA : genomically stable (diffuse, RHOA/CLDN18-ARHGAP fusions)
  • TCGA : chromosomal instability (HER2, EGFR, MET amplification)
  • HER2-positive (~15-20%)
  • CLDN18.2-positive ≥75% (~38%)
  • FGFR2b-overexpressing (~30% any; ~16% at ≥10% 2+/3+)
  • Hereditary diffuse gastric cancer (germline CDH1)
  • GEJ tumours by Siewert type
Biomarkers clinicians test

Target prevalence in this cancer

Target / alterationPrevalenceSource
FAP
>85%
Wikipedia
CEACAM5
50-60%
Wikipedia
Claudin 18.2
SPOTLIGHT/GLOW screening
35-40%
Wikipedia
WRN helicase (MSI-high cancers)
20%
HER2
ToGA screening
15-20%
Wikipedia
FGFR2
FORTITUDE-101 selected IHC 2+/3+
3-8%
cBioPortal (TCGA)
MET
2-5%
cBioPortal (TCGA)

How common each drug target or alteration is in this cancer. Population-level and approximate; see the target page for detail. Full matrix.

History

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  1. 1881Billroth performs the first successful gastrectomy for cancer
    Robotic & minimally invasive surgery
  2. 1965Lauren describes intestinal and diffuse types
    Lauren classification (intestinal vs diffuse)
  3. 1983Helicobacter pylori identified (Marshall and Warren)

    Later classified as a class I carcinogen (1994); eradication shown to reduce gastric cancer incidence.

    Chemoprevention & risk-reducing surgery
  4. 1990Japan and Korea institute endoscopic screening programmes

    Shift to early-stage diagnosis and 5-year survival >60%.

  5. 2006MAGIC: perioperative chemotherapy improves survival (ECF)
    Cytotoxic chemotherapy
  6. 2010ToGA: trastuzumab in HER2+ gastric cancer
    Trastuzumab
  7. 2010ToGA: trastuzumab, the first targeted therapy in gastric cancer
    ToGATrastuzumab
  8. 2014TCGA molecular classification; RAINBOW establishes ramucirumab + paclitaxel
    RAINBOWRamucirumab
  9. 2017Nivolumab third line (ATTRACTION-2); pembrolizumab for MSI-high tumours
    NivolumabPembrolizumabMicrosatellite instability (MSI-H) / mismatch repair deficiency (dMMR)
  10. 2019FLOT4: docetaxel quadruplet becomes perioperative standard; trifluridine/tipiracil third line (TAGS)
    FLOT (5-FU, leucovorin, oxaliplatin, docetaxel)Trifluridine/tipiracil
  11. 2021Nivolumab + chemotherapy first line
    Nivolumab
  12. 2021CheckMate 649: nivolumab + chemotherapy first line; KEYNOTE-811 adds pembrolizumab to trastuzumab; T-DXd approved (DESTINY-Gastric01)
    CheckMate 649Trastuzumab deruxtecan
  13. 2023SPOTLIGHT and GLOW: Claudin 18.2 validated; KEYNOTE-859
    SPOTLIGHT & GLOWKEYNOTE-859
  14. 2024Zolbetuximab: first CLDN18.2 drug
  15. 2024Zolbetuximab approved (Japan March, US October); zanidatamab approved in biliary cancer
    ZolbetuximabZanidatamab
  16. 2025Satri-cel CAR-T approved in China
    Satricabtagene autoleucel
  17. 2025MATTERHORN: perioperative durvalumab approved; DESTINY-Gastric04 phase 3; satri-cel CAR-T approved in China; FORTITUDE-101 mixed; CheckMate 649 five-year data
    MATTERHORNDESTINY-Gastric04Satricabtagene autoleucelFORTITUDE-101CheckMate 649
  18. 2026HERIZON-GEA-01: zanidatamab beats trastuzumab; CLARITY-Gastric 01: first CLDN18.2 ADC with OS benefit
    HERIZON-GEA-01CLARITY-Gastric 01

Pipeline

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Phase 3ADC
Sonesitatug vedotin
Under reviewCAR-T (Claudin 18.2)
Satricabtagene autoleucel
Not filedADC
Disitamab vedotin
ApprovedBiparatopic bispecific antibody (HER2)
Zanidatamab · Ziihera
Phase 3Monoclonal antibody (anti-FGFR2b)
Bemarituzumab
ApprovedADC
Trastuzumab deruxtecan · Enhertu
FAPI PETHERIZON-GEA-01CLARITY-Gastric 01FORTITUDE-101Biomarker-directed first-line quadruplets in gastric cancerPeritoneal-directed therapy for gastric cancerHER2 sequence in gastric cancer: zanidatamab/trastuzumab + chemo ± PD-1 → T-DXdCLDN18.2 antibody first line → CLDN18.2 ADC or CAR-T on progressionMRD / molecular residual disease testing

Open problems

  • Peritoneal metastasis.
  • Heterogeneous CLDN18.2/HER2 expression.
  • Screening only in Japan/Korea.
  • Peritoneal metastasis is the dominant relapse pattern and is poorly imaged, poorly penetrated by drugs, and excluded from most trials.
  • Diffuse-type and genomically stable tumours lack targets and respond poorly to chemotherapy and immunotherapy.
  • Biomarker overlap (CLDN18.2 with PD-L1) has no randomised guidance on combination versus sequence.
  • HER2 and CLDN18.2 expression are heterogeneous and can be lost at progression; re-biopsy or ctDNA before second-line targeting is not standard.
  • No Western screening strategy; most patients present with advanced disease.
  • FGFR2b benefit is uncertain after FORTITUDE-101; the control arm lacked immunotherapy.
  • Perioperative immunotherapy benefit by PD-L1 or MSI status, and whether chemotherapy can be omitted in MSI-high disease, are unresolved.

Trials

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Recruiting now (live from ClinicalTrials.gov)

Recruiting trials near you · live from ClinicalTrials.gov
Gastric & gastro-oesophageal junction cancer
condition: gastric cancer
Open on ClinicalTrials.gov →

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Landmark trials in OnCo

Add-AspirinCheckMate 577CheckMate 649CLARITY-Gastric 01DESTINY-Gastric04FORTITUDE-101HERIZON-GEA-01KEYNOTE-859Low-dose olanzapine for cancer anorexia (Tata Memorial)MATTERHORNRAINBOWSPOTLIGHT & GLOWToGA

Expert centres

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Where the expertise is

Centres linked to this cancer in OnCo

Seeking a second opinion: ask your oncologist for a referral to a high-volume centre; most accept records and pathology by mail or telehealth. In the US, use the NCI's Find a Cancer Center tool or the nonprofit Cancer Commons, which navigates options for advanced cancers at no cost.

Questions to ask

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Bring to your appointment

Questions to ask your oncologist about Gastric & gastro-oesophageal junction cancer

Generated from this cancer's standard of care, biomarkers, and pipeline · 42 questions

Newly diagnosed

  1. What is my exact diagnosis, stage, and grade, and which tests established them?
    Why: Everything else follows from an accurate stage and subtype.
  2. Which biomarkers have been tested on my tumour (for example HER2, PD-L1 CPS, CLDN18.2, MSI, FGFR2b), and what were the results?
    Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
  3. Which subtype is my cancer, and does that change the recommended treatment?
    Why: Recognised subtypes for this cancer include Intestinal type, Diffuse / signet-ring type, TCGA: EBV-positive.
  4. Is germline (inherited) genetic testing recommended for me or my family?
    Why: Inherited variants can change treatment and matter for relatives.

Localised

  1. For my situation (localised), which of the standard options do you recommend and why?
    Why: Guideline options include: Perioperative FLOT ± durvalumab; D2 gastrectomy.
  2. Am I a candidate for Durvalumab, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Advanced first line

  1. For my situation (advanced first line), which of the standard options do you recommend and why?
    Why: Guideline options include: Chemotherapy + PD-1 ± trastuzumab ± zolbetuximab by biomarker.
  2. Am I a candidate for Nivolumab, Pembrolizumab, Trastuzumab, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Later lines

  1. For my situation (later lines), which of the standard options do you recommend and why?
    Why: Guideline options include: T-DXd (HER2+), zanidatamab, CLDN18.2 CAR-T/ADC in trials.
  2. Am I a candidate for Trastuzumab deruxtecan, Zanidatamab, Satricabtagene autoleucel or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Prevention and screening

  1. For my situation (prevention and screening), which of the standard options do you recommend and why?
    Why: Guideline options include: H. pylori eradication reduces incidence; endoscopic screening programmes in Japan and Korea (biennial from age 40-50) detect most cancers at a curable stage. No population screening in the West. Prophylactic total gastrectomy for germline CDH1 carriers.

Early (T1a) disease

  1. For my situation (early (t1a) disease), which of the standard options do you recommend and why?
    Why: Guideline options include: Endoscopic submucosal dissection for well-differentiated mucosal tumours ≤2 cm without ulceration (expanded criteria in Japan); otherwise gastrectomy.

Resectable stage II-III (Western)

  1. For my situation (resectable stage ii-iii (western)), which of the standard options do you recommend and why?
    Why: Guideline options include: Perioperative FLOT + durvalumab (MATTERHORN: OS HR 0.78, pCR 19%) with D2 gastrectomy; FOLFOX/CAPOX perioperatively for patients unfit for docetaxel.
  2. Am I a candidate for FLOT (5-FU, leucovorin, oxaliplatin, docetaxel), Durvalumab, CAPOX (capecitabine, oxaliplatin), and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of MATTERHORN apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Resectable stage II-III (Asian practice)

  1. For my situation (resectable stage ii-iii (asian practice)), which of the standard options do you recommend and why?
    Why: Guideline options include: D2 gastrectomy then adjuvant S-1 (ACTS-GC) or CAPOX (CLASSIC) for 6-12 months; neoadjuvant approaches increasingly adopted.
  2. Am I a candidate for CAPOX (capecitabine, oxaliplatin), and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Advanced, HER2-positive, first line

  1. For my situation (advanced, her2-positive, first line), which of the standard options do you recommend and why?
    Why: Guideline options include: Trastuzumab + fluoropyrimidine/platinum + pembrolizumab (KEYNOTE-811, PD-L1 CPS ≥1); zanidatamab + chemotherapy ± tislelizumab after HERIZON-GEA-01 (PFS 12.4 vs 8.1 months; sBLA 2026).
  2. Am I a candidate for Trastuzumab, Zanidatamab, Pembrolizumab or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of ToGA and HERIZON-GEA-01 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Advanced, HER2-negative, PD-L1 CPS ≥5 (or ≥1), first line

  1. For my situation (advanced, her2-negative, pd-l1 cps ≥5 (or ≥1), first line), which of the standard options do you recommend and why?
    Why: Guideline options include: Nivolumab (CheckMate 649) or pembrolizumab (KEYNOTE-859) or tislelizumab (RATIONALE-305) with FOLFOX or CAPOX; add zolbetuximab if CLDN18.2-positive (sequencing/combination under study).
  2. Am I a candidate for Nivolumab, Pembrolizumab, Tislelizumab or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of CheckMate 649 and KEYNOTE-859 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Advanced, CLDN18.2-positive (≥75%), HER2-negative, first line

  1. For my situation (advanced, cldn18.2-positive (≥75%), her2-negative, first line), which of the standard options do you recommend and why?
    Why: Guideline options include: Zolbetuximab + mFOLFOX6 or CAPOX (SPOTLIGHT/GLOW). PD-L1 CPS ≥5 double-positives: either add-on; combination trials ongoing.
  2. Am I a candidate for Zolbetuximab, FOLFOX (5-FU, leucovorin, oxaliplatin), CAPOX (capecitabine, oxaliplatin), and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of SPOTLIGHT & GLOW apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Advanced, HER2-negative, PD-L1 CPS <1 and CLDN18.2-negative

  1. For my situation (advanced, her2-negative, pd-l1 cps <1 and cldn18.2-negative), which of the standard options do you recommend and why?
    Why: Guideline options include: FOLFOX or CAPOX chemotherapy alone; MSI-high tumours get PD-1 blockade regardless of CPS.
  2. Am I a candidate for FOLFOX (5-FU, leucovorin, oxaliplatin), CAPOX (capecitabine, oxaliplatin), and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Second line, HER2-positive

  1. For my situation (second line, her2-positive), which of the standard options do you recommend and why?
    Why: Guideline options include: Trastuzumab deruxtecan 6.4 mg/kg (DESTINY-Gastric04, OS 14.7 vs 11.4 months) if HER2 persists on re-biopsy or ctDNA.
  2. Am I a candidate for Trastuzumab deruxtecan, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of DESTINY-Gastric04 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Second line, HER2-negative

  1. For my situation (second line, her2-negative), which of the standard options do you recommend and why?
    Why: Guideline options include: Ramucirumab + paclitaxel (RAINBOW, OS 9.6 vs 7.4 months); CLDN18.2-positive: sonesitatug vedotin after CLARITY-Gastric 01 (2026) or satri-cel CAR-T (China).
  2. Am I a candidate for Ramucirumab, Paclitaxel / nab-paclitaxel, Sonesitatug vedotin or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of RAINBOW and CLARITY-Gastric 01 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Third line and beyond

  1. For my situation (third line and beyond), which of the standard options do you recommend and why?
    Why: Guideline options include: Trifluridine/tipiracil (TAGS, OS 5.7 vs 3.6 months); irinotecan; clinical trials (FGFR2b, CLDN18.2 bispecifics, T-cell engagers).
  2. Am I a candidate for Trifluridine/tipiracil, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Peritoneal metastases

  1. For my situation (peritoneal metastases), which of the standard options do you recommend and why?
    Why: Guideline options include: Systemic therapy; intraperitoneal paclitaxel, HIPEC, and PIPAC in trials; palliative gastrectomy not recommended (REGATTA).

Any stage

  1. Are there clinical trials I could join, for example of Sonesitatug vedotin, Satricabtagene autoleucel, Disitamab vedotin, Zanidatamab?
    Why: Trials are how the next standard of care is set; asking early keeps options open.
  2. Would a second opinion at a high-volume centre change anything, and can you help arrange it?
    Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
  3. What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
    Why: Supportive care improves quality of life and helps patients complete treatment.
  4. I read that “Peritoneal metastasis”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.
  5. I read that “Heterogeneous CLDN18.2/HER2 expression”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.

Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.

Everything relevant

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Direct links plus the targets, companies, and technologies of this cancer's products.

technologies

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Anti-angiogenic therapyAntibody-drug conjugate (ADC)Aspirin for cancer prevention and adjuvant therapyBispecific antibodiesCachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapineCancer neuroscience: cutting the nerve supplyCancer-associated thrombosis prevention and treatmentCAR-T cell therapyChemoprevention & risk-reducing surgeryCompanion diagnosticsCytotoxic chemotherapyEndoscopic resection (EMR / ESD)Enhanced recovery (ERAS) and perioperative nutritionEnteral and parenteral nutrition supportFAPI PETGermline (hereditary) testingHER2 PETHIPEC / PIPAC (intraperitoneal chemotherapy)Immune checkpoint inhibitorsImmunonutrition before cancer surgeryIMRT / IGRT (modern external beam)Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy)Mediterranean and plant-forward dietary patternsMonoclonal antibodiesMRD / molecular residual disease testingNutrition support and cachexia managementOncology nutrition assessment and medical nutrition therapyPlatinum agentsRed and processed meat reductionResistance training and protein for cachexia and sarcopeniaRobotic & minimally invasive surgeryTopoisomerase-I inhibitors (and ADC payloads)Vitamin D and omega-3 supplementation

targets

12
CEACAM5Claudin 18.2CTLA-4EpCAMFAPFGFR2HER2METPD-1PD-L1VEGF / VEGFRWRN helicase (MSI-high cancers)

drugs

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Phase 3Monoclonal antibody (anti-FGFR2b)
Bemarituzumab
Not filedBispecific antibody (PD-1×CTLA-4)
Cadonilimab · Kaitanni
Not mapped hereCytotoxic regimen
CAPOX (capecitabine, oxaliplatin)
Not filedADC
Disitamab vedotin
ApprovedCytotoxic chemotherapy (taxane)
Docetaxel · Taxotere (generic)
ApprovedMonoclonal antibody (anti-PD-L1)
Durvalumab · Imfinzi
Not mapped hereCytotoxic regimen
FLOT (5-FU, leucovorin, oxaliplatin, docetaxel)
Not mapped hereFluoropyrimidine antimetabolite
Fluorouracil (5-FU) · Adrucil / Efudex
Not mapped hereCytotoxic regimen
FOLFOX (5-FU, leucovorin, oxaliplatin)
Not mapped hereAlkylating antibiotic (bioreductive)
Mitomycin C · Mutamycin / Jelmyto / Zusduri
ApprovedMonoclonal antibody (anti-PD-1)
Nivolumab · Opdivo / Opdivo Qvantig (SC)
Not mapped hereThird-generation platinum (DACH-platinum)
Oxaliplatin · Eloxatin
ApprovedCytotoxic chemotherapy (taxane)
Paclitaxel / nab-paclitaxel · Taxol / Abraxane
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
ApprovedMonoclonal antibody (anti-VEGFR2)
Ramucirumab · Cyramza
Under reviewCAR-T (Claudin 18.2)
Satricabtagene autoleucel
Phase 3ADC
Sonesitatug vedotin
ApprovedMonoclonal antibody (anti-PD-1)
Tislelizumab · Tevimbra
ApprovedMonoclonal antibody (anti-HER2)
Trastuzumab · Herceptin (and biosimilars, Phesgo with pertuzumab)
ApprovedBiosimilar monoclonal antibody (anti-HER2)
Trastuzumab biosimilars · Ogivri, Herzuma, Kanjinti, Trazimera, Ontruzant, Hercessi
ApprovedADC
Trastuzumab deruxtecan · Enhertu
ApprovedCytotoxic chemotherapy (oral nucleoside)
Trifluridine/tipiracil · Lonsurf
ApprovedBiparatopic bispecific antibody (HER2)
Zanidatamab · Ziihera
ApprovedMonoclonal antibody (anti-Claudin 18.2)
Zolbetuximab · Vyloy

companies

20
AkesoAmgenAstellasAstraZenecaBeOne Medicines (formerly BeiGene)Bristol Myers SquibbCARsgen TherapeuticsDaiichi SankyoEli Lilly (incl. Loxo)Jazz PharmaceuticalsKeymed Biosciences (KYM Biosciences)Merck & Co. (MSD)Pfizer (incl. Seagen)RemeGenRoche / GenentechSanofiServierSOFIE BiosciencesTakedaZymeworks

institutions

39
Aichi Cancer CenterAsan Medical CenterAustralasian Gastro-Intestinal Trials GroupCancer Institute Hospital of JFCRCancer Institute of Iran, Imam Khomeini Hospital ComplexChinese Society of Clinical OncologyFirst Affiliated Hospital of Sun Yat-sen UniversityFundación Arturo López PérezHenan Cancer HospitalHunan Cancer HospitalINCLIVA Biomedical Research Institute / Hospital Clínico Universitario de ValenciaInstituto Nacional de Cancerología (Colombia)Instituto Nacional de Cancerología (Mexico)Instituto Nacional de Enfermedades NeoplásicasInstituto Português de Oncologia do Porto Francisco GentilIstituto di Candiolo IRCCS – FPOJapan Clinical Oncology Group (JCOG)Keio University HospitalKorean Cancer Study GroupKyoto University HospitalKyushu University HospitalNational Cancer Center HospitalNational Cancer Center Hospital EastNational Cancer Center KoreaNational University Hospital / National University Cancer Institute, SingaporeOlivia Newton-John Cancer Wellness and Research CentreOsaka International Cancer InstitutePeking University Cancer HospitalRuijin Hospital, Shanghai Jiao Tong UniversitySamsung Medical CenterSeoul National University HospitalShizuoka Cancer CenterSun Yat-sen University Cancer CenterTaipei Veterans General HospitalTohoku University HospitalUniversity of Hawai'i Cancer CenterVietnam National Cancer Hospital (K Hospital)West Japan Oncology GroupZhongshan Hospital, Fudan University

pathways

7
Cancer cachexiaMismatch repair & microsatellite instabilityPD-1 / PD-L1 immune checkpoint & T-cell activationPI3K / AKT / mTORRAS / RAF / MEK / ERK (MAPK)Receptor tyrosine kinase activationVEGF angiogenesis

terms

25
ADCC (antibody-dependent cellular cytotoxicity)AdenocarcinomaAdenocarcinomaCancer cachexiaCombined positive score (CPS)EMR and ESD (endoscopic mucosal resection, endoscopic submucosal dissection)Endoscopy (EGD, EUS, ERCP)Epstein-Barr virus (EBV) in cancerFLOT regimen (perioperative chemotherapy for gastric cancer)FOLFOX, FOLFIRI, FOLFIRINOX and CAPOXGastrectomyGastro-oesophageal junction (GEJ)HER2-positive (IHC 3+ or ISH-amplified)HIPEC (hyperthermic intraperitoneal chemotherapy)Interstitial lung disease (ILD) / pneumonitisIntraperitoneal (IP) chemotherapyLauren classification (intestinal vs diffuse)Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)Neoadjuvant / adjuvant / perioperativeNutrition impact symptomsObesity-related cancers (IARC list of 13)OesophagectomyPeritoneal metastasisPeritoneum and peritoneal metastasesSiewert classification (GEJ tumours)

trials

13
Add-AspirinCheckMate 577CheckMate 649CLARITY-Gastric 01DESTINY-Gastric04FORTITUDE-101HERIZON-GEA-01KEYNOTE-859Low-dose olanzapine for cancer anorexia (Tata Memorial)MATTERHORNRAINBOWSPOTLIGHT & GLOWToGA

pairings

2
CLDN18.2 antibody first line → CLDN18.2 ADC or CAR-T on progressionHER2 sequence in gastric cancer: zanidatamab/trastuzumab + chemo ± PD-1 → T-DXd

ideas

34
A biomarker-directed trial of vitamin D after surgery for digestive tract cancersA cheap old tablet to restore appetiteA delivery-science moonshot for prevention we already ownA dietitian in every gastrointestinal and head and neck tumour boardA ten-dollar blood test for the five cancers that kill most people in poorer countriesA vaccine against H. pylori for children in high-risk regionsA video-based surgical quality registry linking assessed skill to cancer outcomesAn Epstein-Barr virus vaccine to prevent nasopharyngeal cancer and lymphomasAntibiotic-resistance testing from a stool sample before treating H. pyloriAttack extrachromosomal DNA, the engine of oncogene amplificationAutomatic palliative care referral triggered by diagnosis, not by declineBiomarker-directed first-line quadruplets in gastric cancerBurden-weighted portfolio targets for every major cancer funderConfirm low-dose olanzapine for appetite and weight in advanced cancer worldwideDedicated cohorts for patients with performance status 2 in first-line trialsDose-finding in older and frail patients, not extrapolation from fit onesEliminate infection-caused cancers: HPV, hepatitis B and C, H. pylori and EBVFamily-based H. pylori test-and-treat to prevent stomach cancerFAP theranostics as a pan-cancer stromal strategyFAPI PET as the workup for MCED positivesGet the one approved appetite drug licensed beyond a single countryIn vivo CAR-T against solid-tumour antigensMultimodal prehabilitation for older patients before major cancer surgeryPeritoneal-directed therapy for gastric cancerPublic risk-adjusted outcome reporting for cancer surgery to drive centralisationRapid diagnostic centres for people with vague but worrying symptomsStanding reflex biomarker panels per tumour type, run without an oncologist's orderStomach cancer serology screening for high-risk migrant communities in low-incidence countriesStructured mentorship so district general surgeons perform common cancer operations safelyTest DPYD, UGT1A1 and TPMT/NUDT15 before the first dose, everywhereTreat cachexia as a disease: GDF-15 blockade plus anabolic and nutrition bundlesTreat cachexia before it startsTreat the body cavity, not the bloodstream, for surface spreadUpfront reduced-dose regimens tested head-to-head in frail older patients

collections

2
CSCO guidelines (China)Japanese oncology guidelines (JSMO, JSCO and organ societies)

people

17
Changsong QiDavid CunninghamFeng WangHaruhiko FukudaJeeyun LeeJin LiKohei ShitaraLin ShenMin-Hee RyuRui-Hua XuSun Young RhaTae-You KimTakeshi SanoWon Ki KangYelena Y. JanjigianYoon-Koo KangYung-Jue Bang

bottlenecks

10
Biomarkers are not validated or standardisedCachexia, toxicity and the limits of the patientFunding follows fashion, not burdenInherited risk is mostly unidentifiedMost lethal cancers are found lateMost of the world has almost no cancer careNo one can predict who responds to immunotherapyPain relief and palliative care are unavailable to mostPrevention we already have is not deployedTrials do not represent the people who get cancer

key papers

3
CheckMate 649: nivolumab plus chemotherapy as first treatment for advanced gastric, gastro-oesophageal junction and oesophageal adenocarcinomaIARC verdict: excess body fat causes 13 cancersSPOTLIGHT: zolbetuximab, the first Claudin 18.2 antibody, added to chemotherapy in gastric cancer

Key papers

3top
rctThe Lancet 2023changed practice
SPOTLIGHT: zolbetuximab, the first Claudin 18.2 antibody, added to chemotherapy in gastric cancer

Patients with newly diagnosed advanced stomach cancer should now have Claudin 18.2 tested alongside HER2, PD-L1 and mismatch repair, because roughly a third will be eligible for zolbetuximab, which adds about three months of median survival. The main practical problem is nausea and vomiting during infusions, which needs aggressive prophylaxis. How to sequence or combine it with immunotherapy in PD-L1-positive tumours is unresolved.

rctThe Lancet 2021changed practice
CheckMate 649: nivolumab plus chemotherapy as first treatment for advanced gastric, gastro-oesophageal junction and oesophageal adenocarcinoma

Patients with newly diagnosed advanced stomach or oesophageal adenocarcinoma whose tumour is HER2-negative and PD-L1 positive (CPS 5 or more, or at least 1 in some regions) should receive chemotherapy with nivolumab (or pembrolizumab, from KEYNOTE-859), which adds about three months of median survival and doubles the chance of being alive at three years. The benefit in PD-L1-negative tumours is doubtful, and these patients may be better served by chemotherapy alone or by trials.

reviewNew England Journal of Medicine 2016changed practice
IARC verdict: excess body fat causes 13 cancers

Maintaining a healthy weight is now established cancer prevention for over a dozen cancer types. For clinicians and policymakers, obesity belongs alongside tobacco and alcohol in prevention strategy. Whether intentional weight loss in adulthood reverses risk is still being studied, including in trials of GLP-1 drugs.

Latest papers

top
Latest papers · live from Europe PMC
Open in Europe PMC

Query for this cancer: (TITLE:"Gastric & gastro-oesophageal junction cancer" OR ABSTRACT:"Gastric & gastro-oesophageal junction cancer") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Gastric & gastro-oesophageal junction cancer, not a curated reading list.

Connected

229top

Pages like this

not linked directly; found by shared links

technologies

29
Anti-angiogenic therapyAntibody-drug conjugate (ADC)Aspirin for cancer prevention and adjuvant therapyBispecific antibodiesCachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapineCancer neuroscience: cutting the nerve supplyCancer-associated thrombosis prevention and treatmentCAR-T cell therapyChemoprevention & risk-reducing surgeryCompanion diagnosticsCytotoxic chemotherapyEndoscopic resection (EMR / ESD)Enhanced recovery (ERAS) and perioperative nutritionEnteral and parenteral nutrition supportFAPI PETGermline (hereditary) testingHER2 PETHIPEC / PIPAC (intraperitoneal chemotherapy)Immune checkpoint inhibitorsImmunonutrition before cancer surgeryMediterranean and plant-forward dietary patternsMonoclonal antibodiesMRD / molecular residual disease testingNutrition support and cachexia managementOncology nutrition assessment and medical nutrition therapyRed and processed meat reductionResistance training and protein for cachexia and sarcopeniaRobotic & minimally invasive surgeryVitamin D and omega-3 supplementation

targets

11
CEACAM5Claudin 18.2EpCAMFAPFGFR2HER2METPD-1PD-L1VEGF / VEGFRWRN helicase (MSI-high cancers)

drugs

24
Phase 3Monoclonal antibody (anti-FGFR2b)
Bemarituzumab
Not filedBispecific antibody (PD-1×CTLA-4)
Cadonilimab · Kaitanni
Not mapped hereCytotoxic regimen
CAPOX (capecitabine, oxaliplatin)
Not filedADC
Disitamab vedotin
ApprovedCytotoxic chemotherapy (taxane)
Docetaxel · Taxotere (generic)
ApprovedMonoclonal antibody (anti-PD-L1)
Durvalumab · Imfinzi
Not mapped hereCytotoxic regimen
FLOT (5-FU, leucovorin, oxaliplatin, docetaxel)
Not mapped hereFluoropyrimidine antimetabolite
Fluorouracil (5-FU) · Adrucil / Efudex
Not mapped hereCytotoxic regimen
FOLFOX (5-FU, leucovorin, oxaliplatin)
Not mapped hereAlkylating antibiotic (bioreductive)
Mitomycin C · Mutamycin / Jelmyto / Zusduri
ApprovedMonoclonal antibody (anti-PD-1)
Nivolumab · Opdivo / Opdivo Qvantig (SC)
Not mapped hereThird-generation platinum (DACH-platinum)
Oxaliplatin · Eloxatin
ApprovedCytotoxic chemotherapy (taxane)
Paclitaxel / nab-paclitaxel · Taxol / Abraxane
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
ApprovedMonoclonal antibody (anti-VEGFR2)
Ramucirumab · Cyramza
Under reviewCAR-T (Claudin 18.2)
Satricabtagene autoleucel
Phase 3ADC
Sonesitatug vedotin
ApprovedMonoclonal antibody (anti-PD-1)
Tislelizumab · Tevimbra
ApprovedMonoclonal antibody (anti-HER2)
Trastuzumab · Herceptin (and biosimilars, Phesgo with pertuzumab)
ApprovedBiosimilar monoclonal antibody (anti-HER2)
Trastuzumab biosimilars · Ogivri, Herzuma, Kanjinti, Trazimera, Ontruzant, Hercessi
ApprovedADC
Trastuzumab deruxtecan · Enhertu
ApprovedCytotoxic chemotherapy (oral nucleoside)
Trifluridine/tipiracil · Lonsurf
ApprovedBiparatopic bispecific antibody (HER2)
Zanidatamab · Ziihera
ApprovedMonoclonal antibody (anti-Claudin 18.2)
Zolbetuximab · Vyloy

companies

13
AmgenAstellasAstraZenecaBeOne Medicines (formerly BeiGene)Bristol Myers SquibbCARsgen TherapeuticsDaiichi SankyoEli Lilly (incl. Loxo)Jazz PharmaceuticalsKeymed Biosciences (KYM Biosciences)Merck & Co. (MSD)RemeGenSOFIE Biosciences

institutions

39
Aichi Cancer CenterAsan Medical CenterAustralasian Gastro-Intestinal Trials GroupCancer Institute Hospital of JFCRCancer Institute of Iran, Imam Khomeini Hospital ComplexChinese Society of Clinical OncologyFirst Affiliated Hospital of Sun Yat-sen UniversityFundación Arturo López PérezHenan Cancer HospitalHunan Cancer HospitalINCLIVA Biomedical Research Institute / Hospital Clínico Universitario de ValenciaInstituto Nacional de Cancerología (Colombia)Instituto Nacional de Cancerología (Mexico)Instituto Nacional de Enfermedades NeoplásicasInstituto Português de Oncologia do Porto Francisco GentilIstituto di Candiolo IRCCS – FPOJapan Clinical Oncology Group (JCOG)Keio University HospitalKorean Cancer Study GroupKyoto University HospitalKyushu University HospitalNational Cancer Center HospitalNational Cancer Center Hospital EastNational Cancer Center KoreaNational University Hospital / National University Cancer Institute, SingaporeOlivia Newton-John Cancer Wellness and Research CentreOsaka International Cancer InstitutePeking University Cancer HospitalRuijin Hospital, Shanghai Jiao Tong UniversitySamsung Medical CenterSeoul National University HospitalShizuoka Cancer CenterSun Yat-sen University Cancer CenterTaipei Veterans General HospitalTohoku University HospitalUniversity of Hawai'i Cancer CenterVietnam National Cancer Hospital (K Hospital)West Japan Oncology GroupZhongshan Hospital, Fudan University

pathways

7
Cancer cachexiaMismatch repair & microsatellite instabilityPD-1 / PD-L1 immune checkpoint & T-cell activationPI3K / AKT / mTORRAS / RAF / MEK / ERK (MAPK)Receptor tyrosine kinase activationVEGF angiogenesis

terms

25
ADCC (antibody-dependent cellular cytotoxicity)AdenocarcinomaAdenocarcinomaCancer cachexiaCombined positive score (CPS)EMR and ESD (endoscopic mucosal resection, endoscopic submucosal dissection)Endoscopy (EGD, EUS, ERCP)Epstein-Barr virus (EBV) in cancerFLOT regimen (perioperative chemotherapy for gastric cancer)FOLFOX, FOLFIRI, FOLFIRINOX and CAPOXGastrectomyGastro-oesophageal junction (GEJ)HER2-positive (IHC 3+ or ISH-amplified)HIPEC (hyperthermic intraperitoneal chemotherapy)Interstitial lung disease (ILD) / pneumonitisIntraperitoneal (IP) chemotherapyLauren classification (intestinal vs diffuse)Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)Neoadjuvant / adjuvant / perioperativeNutrition impact symptomsObesity-related cancers (IARC list of 13)OesophagectomyPeritoneal metastasisPeritoneum and peritoneal metastasesSiewert classification (GEJ tumours)

trials

13
Add-AspirinCheckMate 577CheckMate 649CLARITY-Gastric 01DESTINY-Gastric04FORTITUDE-101HERIZON-GEA-01KEYNOTE-859Low-dose olanzapine for cancer anorexia (Tata Memorial)MATTERHORNRAINBOWSPOTLIGHT & GLOWToGA

pairings

2
CLDN18.2 antibody first line → CLDN18.2 ADC or CAR-T on progressionHER2 sequence in gastric cancer: zanidatamab/trastuzumab + chemo ± PD-1 → T-DXd

ideas

34
A biomarker-directed trial of vitamin D after surgery for digestive tract cancersA cheap old tablet to restore appetiteA delivery-science moonshot for prevention we already ownA dietitian in every gastrointestinal and head and neck tumour boardA ten-dollar blood test for the five cancers that kill most people in poorer countriesA vaccine against H. pylori for children in high-risk regionsA video-based surgical quality registry linking assessed skill to cancer outcomesAn Epstein-Barr virus vaccine to prevent nasopharyngeal cancer and lymphomasAntibiotic-resistance testing from a stool sample before treating H. pyloriAttack extrachromosomal DNA, the engine of oncogene amplificationAutomatic palliative care referral triggered by diagnosis, not by declineBiomarker-directed first-line quadruplets in gastric cancerBurden-weighted portfolio targets for every major cancer funderConfirm low-dose olanzapine for appetite and weight in advanced cancer worldwideDedicated cohorts for patients with performance status 2 in first-line trialsDose-finding in older and frail patients, not extrapolation from fit onesEliminate infection-caused cancers: HPV, hepatitis B and C, H. pylori and EBVFamily-based H. pylori test-and-treat to prevent stomach cancerFAP theranostics as a pan-cancer stromal strategyFAPI PET as the workup for MCED positivesGet the one approved appetite drug licensed beyond a single countryIn vivo CAR-T against solid-tumour antigensMultimodal prehabilitation for older patients before major cancer surgeryPeritoneal-directed therapy for gastric cancerPublic risk-adjusted outcome reporting for cancer surgery to drive centralisationRapid diagnostic centres for people with vague but worrying symptomsStanding reflex biomarker panels per tumour type, run without an oncologist's orderStomach cancer serology screening for high-risk migrant communities in low-incidence countriesStructured mentorship so district general surgeons perform common cancer operations safelyTest DPYD, UGT1A1 and TPMT/NUDT15 before the first dose, everywhereTreat cachexia as a disease: GDF-15 blockade plus anabolic and nutrition bundlesTreat cachexia before it startsTreat the body cavity, not the bloodstream, for surface spreadUpfront reduced-dose regimens tested head-to-head in frail older patients

collections

2
CSCO guidelines (China)Japanese oncology guidelines (JSMO, JSCO and organ societies)

people

17
Changsong QiDavid CunninghamFeng WangHaruhiko FukudaJeeyun LeeJin LiKohei ShitaraLin ShenMin-Hee RyuRui-Hua XuSun Young RhaTae-You KimTakeshi SanoWon Ki KangYelena Y. JanjigianYoon-Koo KangYung-Jue Bang

bottlenecks

10
Biomarkers are not validated or standardisedCachexia, toxicity and the limits of the patientFunding follows fashion, not burdenInherited risk is mostly unidentifiedMost lethal cancers are found lateMost of the world has almost no cancer careNo one can predict who responds to immunotherapyPain relief and palliative care are unavailable to mostPrevention we already have is not deployedTrials do not represent the people who get cancer

key papers

3
CheckMate 649: nivolumab plus chemotherapy as first treatment for advanced gastric, gastro-oesophageal junction and oesophageal adenocarcinomaIARC verdict: excess body fat causes 13 cancersSPOTLIGHT: zolbetuximab, the first Claudin 18.2 antibody, added to chemotherapy in gastric cancer