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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2016; 22(28): 6373-6384
Published online Jul 28, 2016. doi: 10.3748/wjg.v22.i28.6373
Immunological battlefield in gastric cancer and role of immunotherapies
Minyu Wang, Rita A Busuttil, Sharon Pattison, Paul J Neeson, Alex Boussioutas
Minyu Wang, Rita A Busuttil, Alex Boussioutas, Cancer Genetics and Genomics Laboratory, Peter MacCallum Cancer Centre, East Melbourne 3002, Victoria, Australia
Minyu Wang, Rita A Busuttil, Paul J Neeson, Alex Boussioutas, Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville 3050, Victoria, Australia
Minyu Wang, Rita A Busuttil, Alex Boussioutas, Department of Medicine, The University of Melbourne, Royal Melbourne Hospital, Parkville 3050, Victoria, Australia
Sharon Pattison, Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin 9016, New Zealand
Sharon Pattison, Southern Blood and Cancer Service, Southern District Health Board, Dunedin 9054, New Zealand
Paul J Neeson, Cancer Immunology Research, Peter MacCallum Cancer Centre, East Melbourne 3002, Victoria, Australia
Paul J Neeson, Pathology Department, University of Melbourne, Parkville 3050, Victoria, Australia
Author contributions: Wang M, Busuttil RA, Pattison S, Neeson PJ and Boussioutas A reviewed the literature and wrote the paper.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
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. Alex Boussioutas, Associate Professor, Department of Medicine, The University of Melbourne, Royal Melbourne Hospital, Grattan Street, Parkville 3050, Victoria, Australia. alex.boussioutas@petermac.org
Telephone: +61-383446252 Fax: +61-3471863
Received: March 28, 2016
Peer-review started: April 1, 2016
First decision: May 12, 2016
Revised: May 25, 2016
Accepted: June 15, 2016
Article in press: June 15, 2016
Published online: July 28, 2016
Processing time: 115 Days and 20.3 Hours
Abstract

Like the wars predating the First World War where human foot soldiers were deemed tools in the battlefield against an enemy, so too are the host immune cells of a patient battling a malignant gastric cancer. Indeed, the tumour microenvironment resembles a battlefield, where the patient’s immune cells are the defence against invading tumour cells. However, the relationship between different immune components of the host response to cancer is more complex than an “us against them” model. Components of the immune system inadvertently work against the interests of the host and become pro-tumourigenic while other components soldier on against the common enemy – the tumour cell.

Keywords: Immune; Gastric cancer; Immune therapy; Immunology; Tumour microenvironment

Core tip: Many solid tumours are now being treated with immunotherapies and gastric cancer is no exception. Here we review the literature on molecular subtypes of gastric cancer and how they each have different immunological responses and hence may be differentially responsive to these immunotherapies. We emphasise that while treatment of gastric cancer may be benefited by immunotherapy we should try to target this based on molecular and immunological signatures of the individual patient. This will match the ideal therapy to the specific patient and is a step forward on the pathos precision medicine.