The possibilities of immunotherapy in the treatment of locally advanced gastric cancer and cardioesophageal transition

In recent years, immune checkpoint inhibitors has made a breakthrough and has become an important treatment most metastatic solid tumors, but the safety and efficacy in the perioperative or neoadjuvant regimes of treatment is currently only under study. We analysed available studies of the use of immunotherapy in locally advanced gastric cancer and and gastroesophageal junction (GC/GEJ). Material and methods. We searched PubMed, Embase, Elibrary databases works dedicated to the effects of the addition of immunotherapy at the neoadjuvant or perioperative treatment in patients with locally advanced GC/GEJ. Results. The addition of immunotherapy to the perioperative treatment of patients with locally advanced gastric cancer does not increase the frequency of adverse events. The frequency of a complete pathological response increase in patients receiving immunochemotherapy (31%). In patients with microsatellite instability, this indicator was even higher (up to 70%). The presented results demonstrate promising safety and efficacy from adding immune checkpoint inhibitors to neoadjuvant therapy for locally advanced gastric cancer and and gastroesophageal junction. Conclusion. In patients with microsatellite instability (MSI), neoadjuvant immunotherapy increased frequency of pCR. The number of adverse events of grade 3 or higher did not significantly increase. Neoadjuvant or perioperative ICI for patients with GC and MSI is included in current clinical guidelines.