Published online May 21, 2015. doi: 10.3748/wjg.v21.i19.5778
Peer-review started: October 18, 2014
First decision: December 2, 2014
Revised: February 19, 2015
Accepted: April 17, 2015
Article in press: April 17, 2015
Published online: May 21, 2015
Processing time: 216 Days and 18.6 Hours
The incidence of gastric cancer (GC) fell dramatically over the last 50 years, but according to IARC-Globocan 2008, it is the third most frequent cause of cancer-related deaths with a case fatality GC ratio higher than other common malignancies. Surgical resection is the primary curative treatment for GC though the overall 5-year survival rate remains poor (approximately 20%-25%). To improve the outcome of resectable gastric cancer, different treatment strategies have been evaluated such as adjuvant or perioperative chemotherapy. In resected gastric cancer, the addition of radiotherapy to chemotherapy does not appear to provide any additional benefit. Moreover, in metastatic patients, chemotherapy is the mainstay of palliative therapy with a median overall survival of 8-10 mo and objective response rates of merely 20%-40%. Therefore, the potential for making key beneficial progress is to investigate the GC molecular biology to realize innovative therapeutic strategies, such as specific immunotherapy. In this review, we provide a panoramic view of the different immune-based strategies used for gastric cancer treatment and the results obtained in the most significant clinical trials. In detail, firstly we describe the therapeutic approaches that utilize the monoclonal antibodies while in the second part we analyze the cell-based immunotherapies.
Core tip: The overall 5-year survival rate of gastric cancer after surgery resection remains poor (approximately 20%-25%) also adopting different treatment strategies, such as adjuvant chemotherapy, adjuvant chemo-radiotherapy and perioperative chemotherapy. Several data support the idea that anti-gastric cancer (GC) specific immunotherapy could be an interesting therapeutic strategy. In this review, we provide a panoramic view of the various immune-based approaches adopted and the results obtained in the most significant clinical trials with GC patients.