Application and challenges of neoadjuvant therapy in gastric cancer in the immunotherapy era.

The emergence of neoadjuvant immunotherapy and neoadjuvant immunotherapy combined with chemotherapy has further elevated the status of neoadjuvant therapy in the treatment of gastric cancer. These new approaches have shown potential in improving the pathologic complete response rate and patient survival rate,providing more treatment options for patients with locally advanced gastric cancer. However,the application of neoadjuvant immunotherapy in gastric cancer still faces some challenges. On the one hand,only a portion of patients can benefit from immunotherapy,and how to accurately screen this group of patients is currently the focus of research. On the other hand,adverse reactions related to immunotherapy also require attention and proper management,such as the occurrence of immune related adverse reactions that may affect patients' quality of life and treatment compliance. Meanwhile,the new adjuvant immunotherapy has brought new challenges to the traditional concept of radical surgery. Such as changes in surgical methods, scope of lymph node dissection, etc. Therefore, in the future, it is necessary to further explore biomarkers that can predict the efficacy of immunotherapy, screen potential beneficiaries, and optimize treatment plans to improve the effectiveness and safety of immunotherapy, in order to achieve the maximum value of neoadjuvant immunotherapy in the treatment of locally advanced gastric cancer.