Gastric Cancer Treatment: New Developments and Clinical Trials in 2025
Stomach cancer rarely makes headlines compared to breast or lung cancer, yet as gastroenterological oncologist Dr. Rutika Mehta explained during our recent "Ask the Expert" session, it demands far more attention. With emerging clinical trials, innovative surgical techniques, and advances in molecular profiling, the gastric cancer treatment landscape is evolving rapidly.
Dr. Rutika Mehta is a board-certified gastrointestinal oncologist with over 15 years of experience in treating digestive system cancers. She specializes in targeted therapies and immunotherapy approaches for gastric and esophageal malignancies, and serves as principal investigator on several clinical trials exploring novel treatment combinations.
Current Treatment Standards and New Developments
"The backbone of treatment hasn't changed," Dr. Mehta explained when asked whether treatments from 2021 would still be used today. Standard approaches still include chemoradiation with cisplatin and 5FU or CarboTaxol, followed by surgical interventions such as total or proximal gastrectomy, depending on tumor location. Published five-year survival rates for localized gastric cancer treated with this multimodal approach range from 68-75% according to the most recent NCCN guidelines.
However, exciting developments are on the horizon. The MATTERHORN clinical trial is currently exploring whether adding immunotherapy to chemotherapy for operable stomach cancers might improve outcomes. Another trial, KUNLUN, investigates immunotherapy's role in treating esophageal squamous cell carcinoma.
These studies signal a significant shift toward biomarker-driven treatment decisions – an uncommon approach in stomach cancer treatment just a few years ago.
Additional information about the MATTERHORN trial protocol and participating centers can be found at ClinicalTrials.gov identifier: NCT04592913
The KUNLUN clinical trial is registered with the National Clinical Trials (NCT) number NCT04550260.
Surgical Innovations Improving Quality of Life
Surgical techniques have also advanced. Approaches like proximal double tract gastrectomy and double flap technique are now available in select cases. Notably, proximal gastrectomy can offer better postoperative quality of life with less weight loss and fewer nutritional issues than total gastrectomy in appropriate patients.
Community members were particularly interested in these surgical innovations, asking detailed questions about variations in use based on medical centers, geography, and surgeon experience. This exchange highlighted the importance of seeking treatment at centers with specialized expertise in gastric cancer.
The National Cancer Institute provides detailed information about various surgical approaches for gastric cancer here.
Living with Gastric Cancer: Patient Concerns
Beyond clinical trials and surgical options, Dr. Mehta addressed practical concerns that profoundly affect daily life for patients:
Pre-surgery preparation:
Importance of maintaining weight
Researching nutritional needs
Questions to ask your surgical team
Post-gastrectomy challenges:
Managing thick saliva
Addressing dumping syndrome
Dealing with malabsorption issues
These discussions emphasized that treatment success isn't measured solely by survival rates but also by quality of life during and after treatment.
Early Detection: A Critical Challenge
"Symptoms are very non-specific," Dr. Mehta explained. "Indigestion, acid reflux—we chalk it up to stress or poor eating habits." This subtlety allows the disease to progress undetected. By the time stomach cancer is diagnosed, it has often reached an advanced stage when treatment options narrow.
Unlike breast or colon cancer, there is no standard screening protocol for most people in the United States (though countries like Japan and Korea implement population-wide screening programs).
Dr. Mehta stressed the importance of comprehensive testing at diagnosis:
Endoscopy and biopsy
CT and PET scans
Laparoscopy
Molecular profiling of tumors
For those with family histories of cancer, she recommends genetic testing for mutations such as CDH1 and Lynch syndrome, and considering early screening options.
For more information on gastric cancer symptoms and risk factors, see the American Cancer Society's comprehensive guide.
The Promise of Targeted Therapies
Recent breakthroughs in targeted therapy offer new hope. The FDA has approved zolbetuximab for CLDN18.2-positive tumors in early 2025, following the SPOTLIGHT and GLOW trials that showed a median overall survival extending beyond 18 months when combined with chemotherapy—a significant improvement over the previous 12-month average for advanced disease.
Additional promising targets include FGFR2b, with bemarituzumab trials currently underway. These developments highlight the growing importance of comprehensive biomarker testing to identify patients who may benefit from these targeted approaches.
Moving Forward: Vigilance and Advocacy
Dr. Mehta's final reflections focused not on drugs or trials—but on vigilance. Her advice to patients and those at risk was clear: Listen to your body. Take symptoms seriously. Ask difficult questions. Push for answers.
For the gastric cancer community, staying informed about emerging treatments and clinical trials remains crucial. As research continues to advance, the hope is that earlier detection and more personalized treatment approaches will improve outcomes for people facing this challenging diagnosis.
Join our stomach cancer community at Smart Patients to connect with others navigating similar challenges