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World J Clin Oncol. Dec 24, 2025; 16(12): 110988
Published online Dec 24, 2025. doi: 10.5306/wjco.v16.i12.110988
Perioperative immunotherapy in gastric cancer in the spotlight
Laura S Pernomian, Maria Fernanda Teixeira, Raphael LC Araujo, Pedro Luiz Serrano Uson Junior
Laura S Pernomian, Maria Fernanda Teixeira, Pedro Luiz Serrano Uson Junior, Center for Personalized Medicine, Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
Raphael LC Araujo, Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC 28204, United States
Raphael LC Araujo, Department of Surgery, Universidade Federal de São Paulo, São Paulo 04024-002, Brazil
Author contributions: Pernomian LS, Teixeira MF, Araujo RL, and Serrano Uson Junior PL designed the study; Pernomian LS and Teixeira MF wrote the manuscript; and all authors revised and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Raphael LC Araujo, MD, PhD, FACS, Department of Surgery, Carolinas Medical Center, Atrium Health, 1025 Morehead Medical Drive, Charlotte, NC 28204, United States. raphael.l.c.araujo@gmail.com
Received: June 23, 2025
Revised: July 27, 2025
Accepted: November 14, 2025
Published online: December 24, 2025
Processing time: 186 Days and 19.4 Hours
Core Tip

Core Tip: Immunotherapy is reshaping the treatment landscape for resectable gastric and gastroesophageal junction cancers. Despite the established benefit of perioperative leucovorin, oxaliplatin, and docetaxel chemotherapy, complete pathological response rates remain below 15%. Recent phase III trials, including KEYNOTE-585 with pembrolizumab and MATTERHORN with durvalumab, have demonstrated improved pathological responses and event-free survival, particularly in biomarker-enriched subgroups such as microsatellite instability-high or programmed death-ligand 1-positive tumors. This article summarizes the evolving evidence supporting immune checkpoint inhibitors in the perioperative setting and highlights future directions toward biomarker-driven, personalized multimodal therapy for gastric cancer.