The Evolution of Neoadjuvant Therapy for Gastric Cancer: History, Current Situation, and Future Precision

Gastric cancer is one of the most common malignant tumors in the world. Gastric cancer continues to represent a major global health concern, with its high mortality rates and widespread incidence contributing to a significant disease burden across diverse populations, and China is also a high-risk area. With the continuous development of treatment methods and clinical trials, the symptoms of early gastric cancer are not easy to detect, and most patients are diagnosed at an advanced stage. Treatment options for distant metastasis are limited. Therefore, the 5-year survival rate of gastric cancer remains low. In recent years, there have been different research data on the efficacy of perioperative adjuvant chemotherapy and postoperative chemotherapy for gastric cancer. However, the results of a number of phase II clinical trials have confirmed that chemotherapy and neoadjuvant chemotherapy have the advantages of reducing tumor volume and clinical stage, thereby improving the R0 resection rate, which can improve the 5-year survival rate of patients to a certain extent. In particular, the effect can be further enhanced after combined immunotherapy and targeted therapy. This review synthesizes recent advancements in the application of neoadjuvant strategies for treating gastric cancer, focusing on their clinical efficacy and evolving therapeutic paradigms.