Clinical Scorecard: Immune Microenvironment Dynamics and Resistance to Immunotherapy in Gastric and Gastroesophageal Junction Adenocarcinoma

At a Glance

Key Highlights

• Immune checkpoint inhibitors are central to managing advanced gastric cancer.
• Durable benefits from immunotherapy are uneven across patients and lesions.
• Current biomarkers do not fully explain antitumor immunity dynamics.
• Spatial immune ecology framework helps interpret immunotherapy resistance.
• Distinct immune ecosystems exist within gastric and gastroesophageal junction adenocarcinoma.

Guideline-Based Recommendations

Diagnosis

• Use PD-L1 scoring, microsatellite instability, and HER2 status for diagnosis.

Management

• Integrate PD-1 blockade with chemotherapy for advanced disease.

Monitoring & Follow-up

• Assess spatial features and immune contexture as pharmacodynamic endpoints.

Risks

• Consider primary, adaptive, and acquired resistance mechanisms.

Patient & Prescribing Data

Patients with advanced gastric or gastroesophageal junction adenocarcinoma.

Current biomarkers are indispensable but incomplete for treatment selection.

Clinical Best Practices

• Evaluate immune contexture and spatial organization in tumors.
• Differentiate between gastric and gastroesophageal junction adenocarcinoma in treatment planning.

Related Resources & Content

• Immune Microenvironment Dynamics and Resistance to Immunotherapy in Gastric and Gastroesophageal Junction Adenocarcinoma