Immune checkpoints aberrations and gastric cancer; assessment of prognostic value and evaluation of therapeutic potentials

• Till now, the prognosis of advanced gastric cancer looked dreadful.
• Unselected use of immune checkpoint inhibitors in gastric cancer has been deemed with failure.
• Pembrolizumab has shown encouraging results in molecularly selected gastric cancer patients.

Till now, the prognosis of advanced gastric cancer looked dreadful; thus the search for newer better approaches for this lethal disease has been a strategic target for cancer researchers. In recent years, important immunobiological aspects of the tumor have been revealed with the subsequent proposal of immune check point inhibitors to target these pathways. Clinically, unselected use of immune checkpoint inhibitors in gastric cancer has been deemed with failure; in contrast to the clear success of more recent studies reporting on the use of pembrolizumab in molecularly selected patients. This may illustrate that any future use of immune checkpoint inhibitors in gastric cancer has to be molecularly supported. This review provides a delicate dissection of the clinical and immunobiological considerations underlying the use of these agents in addition to a thorough review of the published clinical data of immune checkpoint inhibitors in gastric cancer.