Checkpoint inhibitors in the treatment of locally advanced and metastatic gastric cancer: A literature review

Abstract

Relevance: Stomach cancer (SC) is one of the most common malignant neoplasms and ranks fifth in cancer incidence worldwide. The only curative approach to localized SC is radical surgery with or without prior chemotherapy. But chemotherapy is the primary treatment method for metastatic or locally advanced SC. In the later stages of SC, there is high resistance to chemotherapy; therefore, there is a need to find modern treatment approaches. Particular attention is paid to therapy for metastatic/locally advanced SC.
The study aimed to describe the possibilities of using immune checkpoint inhibitors (CPI) to treat metastatic or locally advanced SC.
Methods: The data from modern literary sources of recent years were studied using specialized scientific search engines: Scopus, PubMed, Google Scholar and Web of Science for the possibility of promising application of various immunotherapeutic approaches in treating metastatic or locally advanced SC.
Results: The article describes modern methods of treatment of metastatic or locally advanced SC using CPIs, including PD-1, PD-L1, and CTLA-4, demonstrates the mechanisms of immunological surveillance, characteristics of PD-1, PD-L1, CTLA-4, and their significance in suppressing the T-cell response. The effectiveness of using CPIs, particularly PD-1, PD-L1, and CTLA-4, has been established in the first and subsequent lines of therapy.
Conclusion: CPIs is a recent finding in antitumor therapy. Frequent resistance of SC to chemotherapy urges the use of CPIs to treat advanced SC.