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REVIEW article

Front. Immunol.

Sec. Cancer Immunity and Immunotherapy

This article is part of the Research TopicCheckpoint immunotherapy: Reshaping the landscape of gastrointestinal cancer treatment - Volume IIView all 12 articles

Immune checkpoint inhibitor therapy for gastric cancer: current status, therapeutic challenges, and future prospects

Provisionally accepted
Penghui  LiuPenghui Liu1Na  LiNa Li1Jiwu  GuoJiwu Guo2Gengyu  Tong ZhaoGengyu Tong Zhao3Jizhen  WangJizhen Wang2Mou  ZiyuanMou Ziyuan1Jie  MaoJie Mao2*
  • 1Lanzhou University, Lanzhou, China
  • 2Lanzhou University Second Hospital, Lanzhou, China
  • 3Northeastern University, Boston, United States

The final, formatted version of the article will be published soon.

Gastric cancer is among the most prevalent malignant tumors of the digestive system worldwide. In recent years, immune checkpoint inhibitors (ICIs) have achieved substantial advances in the treatment of gastric cancer. By blocking the PD-1/PD-L1 and CTLA-4 signaling pathways, ICIs enhance antitumor immune responses and offer novel therapeutic options for patients. However, their clinical application continues to face significant challenges, including therapeutic resistance, immune-related adverse events, the lack of reliable biomarkers, and an immunosuppressive tumor microenvironment. This narrative review summarizes recent advances in ICIs-based therapies for gastric cancer, provides an in-depth analysis of existing clinical challenges, and highlights key future research directions, including biomarker discovery, development of predictive models, optimization of combination regimens, targeting of resistance mechanisms, modulation of the tumor-associated microbiota, and improved toxicity management. Moving forward, efforts should focus on advancing immunotherapy toward individualized and precision-based approaches to maximize both efficacy and safety, thereby enabling further optimization and breakthroughs in gastric cancer immunotherapy.

Keywords: efficacy and safety, gastric cancer, immune checkpoint inhibitors, Immunotherapy, Personalizedtreatment

Received: 01 Oct 2025; Accepted: 16 Feb 2026.

Copyright: © 2026 Liu, Li, Guo, Zhao, Wang, Ziyuan and Mao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jie Mao

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