Gastric cancer drug development has long been thwarted by the challenges of identifying effective targets and developing drugs against the backdrop of the cancer’s inherent tumor heterogeneity.1 Recently, however, advances in our understanding of the molecular underpinnings of gastric cancer and the discovery of actionable biomarkers have led to substantial progress in drug development, leading to improved survival in gastric cancer.
Although systemic chemotherapy remains the backbone of therapy even today, the past few years have provided us with multiple new U.S. Food and Drug Administration–approved drugs that make us hopeful that we are at an inflection point in gastric cancer drug development.2 Expression of HER2 and PD-L1 and mismatch repair (MMR) deficiency have all opened avenues for novel therapies in recent years, and most recently, promising data targeting claudin 18.2 has surfaced in patients with HER2-negative advanced gastric cancer.