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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2015; 21(19): 5778-5793
Published online May 21, 2015. doi: 10.3748/wjg.v21.i19.5778
Gastric cancer and the epoch of immunotherapy approaches
Elena Niccolai, Antonio Taddei, Domenico Prisco, Amedeo Amedei
Elena Niccolai, Domenico Prisco, Amedeo Amedei, Department of Experimental and Clinical Medicine, University of Florence, 50134 Firenze, Italy
Antonio Taddei, Department of Surgery and Translational Medicine, University of Florence, 50134 Florence, Italy
Antonio Taddei, Department of Biomedicine, Azienda Ospedaliera Universitaria Careggi, 50134 Florence, Italy
Domenico Prisco, Amedeo Amedei, SOD Medicina Interna Interdisciplinare - DAI Neuromuscoloscheletrico e degli organi di senso, Azienda Ospedaliera Universitaria Careggi, 50134 Firenze, Italy
Author contributions: Niccolai E, Taddei A and Prisco D equally contributed in drafting the article; Amedei A had the substantial contributions to conception and design of the manuscript; all the authors have approved the final version of the article.
Supported by grant from the Italian Ministry of University and Research, No. Prin 2009FZZ4XM_002.
Conflict-of-interest: The authors certify that no actual or potential conflict of interest in relation to this article exists.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Amedeo Amedei, Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Firenz, Italy. aamedei@unifi.it
Telephone: +39-55-4271495 Fax: +39-55-427149
Received: October 15, 2014
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
Abstract

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.

Keywords: Gastric cancer; Immunotherapy; Monoclonal antibodies; T cells; Dendritic cells; NK cells

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.