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Why Gastric Immunotherapy Works Differently

First-line immunotherapy has reshaped treatment for advanced HER2-negative gastric cancer, but its benefits do not appear to be shared equally across populations. This review shows that Asian patients often derive greater survival benefit than non-Asian patients when immune checkpoint inhibitors are combined with chemotherapy. Rather than attributing the gap to one factor, the authors outline a broader explanation involving clinicopathologic patterns, mutation profiles, molecular subtypes, immune landscapes, Helicobacter pylori exposure, and gut microbiome differences. The findings suggest that gastric cancer immunotherapy may need to move beyond a one-size-fits-all model toward more population-aware precision treatment.

March 25, 2026


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