The evolution of cellular-based immunotherapy in the treatment of gastric cancer: an overview of clinical trials

Despite advances in patients’ healthcare, gastric cancer remains a major health concern around the world with a high annual incidence rate and mortality. This highlights the urgent need to develop more effective therapeutic strategies, particularly for patients in advanced stages of the disease. In the recent decade, cellular-based immunotherapy has achieved remarkable successes in various hematologic malignancies and solid tumors. Nonetheless, until now, no cellular-based immunotherapy has been approved for GC patients. This review aims to provide a holistic view of the current state of cellular-based immunotherapy for GC, its existing bottlenecks, and future directions to harness the potential of cellular-based immunotherapy for GC treatment. In this regard, we explore clinical trials of various types of cellular-based immunotherapy, including chimeric antigen receptor (CAR)-engineered cell therapy, T cell receptor (TCR)-engineered T cell therapy, tumor-infiltrating lymphocyte (TIL) therapy, cytokine-induced killer (CIK) cell therapy, and dendritic cell (DC) vaccines. For each type of cellular-based immunotherapy, we discuss existing roadblocks to successful treatment and explore potential solutions that may improve efficacy, including novel targets, combination approaches, and biomarker-driven patient selection.