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Yet complete response rates in the perioperative setting remain below 10%–15%, creating demand for more effective strategies. Emerging evidence from pembrolizumab (KEYNOTE-585) and durvalumab (MATTERHORN) suggests improved response and event-free survival, but these approaches are not standard of care. The article reviews the perioperative treatment landscape and future directions.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/perioperative-immunotherapy-in-gastric-cancer-in-the-spotlight-minireviews/406244/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/perioperative-immunotherapy-in-gastric-cancer-in-the-spotlight-minireviews/406244.png","ImageObject",300,407,{"name":92,"@type":93},"วิน","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the current standard perioperative chemotherapy for resectable gastric cancer?","Question",{"text":113,"@type":114},"Perioperative fluorouracil, leucovorin, oxaliplatin, and docetaxel is described as the current standard based on FLOT4 and ESOPEC trials.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Why is there interest in perioperative immunotherapy?",{"text":118,"@type":114},"Complete response rates with perioperative chemotherapy remain below about 10%–15%, indicating unmet need for more effective regimens.",{"name":120,"@type":111,"acceptedAnswer":121},"Which perioperative immunotherapy trials are highlighted, and what outcomes are reported?",{"text":122,"@type":114},"KEYNOTE-585 with pembrolizumab and MATTERHORN with durvalumab are highlighted, showing promising improvements in response rates and event-free survival, though not yet standard of care.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},406244,1790818494,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":105,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336475104736,"https://ap-avatar.wpscdn.com/avatar/22000c4c5e0e5b17e70?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786591360781797222","| W | J | C | O | World Journal of\u003Cbr>Clinical Oncology |\n| --- | --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Clin Oncol 2025 December 24; 16(12): 110988  \nDOI: 10.5306/wjco.v16.i12.110988 ISSN 2218-4333 (online)  \nMINIREVIEWS  \nPerioperative immunotherapy in gastric cancer in the spotlight  \nLaura S Pernomian, Maria Fernanda Teixeira, Raphael LC Araujo, Pedro Luiz Serrano Uson Junior  \nSpecialty type: Oncology  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade C  \nNovelty: Grade D  \nCreativity or Innovation: Grade D  \nScientific Significance: Grade C  \nP-Reviewer: Wei JP, MD, PhD, China  \nReceived: June 23, 2025  \nRevised: July 27, 2025  \nAccepted: November 14, 2025  \nPublished online: December 24, 2025  \nProcessing time: 186 Days and 4.6 Hours  \nLaura S Pernomian, Maria Fernanda Teixeira, Pedro Luiz Serrano Uson Junior, Center for Personalized Medicine, Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil  \nRaphael LC Araujo, Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC 28204, United States  \nRaphael LC Araujo, Department of Surgery, Universidade Federal de São Paulo, São Paulo 04024-002, Brazil  \nCorresponding author: Raphael LC Araujo, MD, PhD, FACS, Department of Surgery, Carolinas Medical Center, Atrium Health, 1025 Morehead Medical Drive, Charlotte, NC 28204, United [States.](States. raphael.l.c.araujo@gmail.com)[ raphael.l.c.araujo@gmail.com](States. raphael.l.c.araujo@gmail.com)  \nAbstract  \nPerioperative fluorouracil, leucovorin, oxaliplatin and docetaxel is currently the standard chemotherapy for resectable gastric and gastroesophageal junction adenocarcinomas, based on the results of FLOT4 and ESOPEC trials. This regimen has demonstrated efficacy in tumor downstaging, enhancing the chances of curative resection, and ultimately improving the overall survival. However, despite these advances, the complete response rate in the perioperative setting remains below 10% to 15%, highlighting the need for more effective treatment strategies. Recent studies evaluating immunotherapy, such as the KEYNOTE-585 trial with pembrolizumab and the MATTERHORN trial with durvalumab, have shown promising preliminary results, including improved response rates and event-free survival. Nevertheless, these regimens are not yet considered the standard of care. This article explores the current landscape of perioperative treatments for gastric cancer and discusses future directions in this field.  \nKey Words: Gastric cancer; Gastroesophageal junction cancer; Perioperative treatment; Neo-adjuvant treatment; Chemotherapy; Immunotherapy; Surgery; Gastrectomy  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \n WJCO  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 24, 2025  Volume 16  Issue 12   \nPernomian LS et al. Perioperative immunotherapy in G/GEJ cancer  \nCore Tip: Immunotherapy is reshaping the treatment landscape for resectable gastric and gastroesophageal junction cancers. Despite the established benefit of perioperative leucovorin, oxaliplatin, and docetaxel chemotherapy, complete pathological response rates remain below 15% . Recent phase III trials, including KEYNOTE-585 with pembrolizumab and MATTERHORN with durvalumab, have demonstrated improved pathological responses and event-free survival, particularly in biomarker-enriched subgroups such as microsatellite instability-high or programmed death-ligand 1-positive tumors. This article summarizes the evolving evidence supporting immune checkpoint inhibitors in the perioperative setting and highlights future directions toward biomarker-driven, personalized multimodal therapy for gastric cancer.  \nCitation: Pernomian LS, Teixeira MF, Araujo RL, Serrano Uson Junior PL. Perioperative immunotherapy in gast","cbCaifK7Ze4MJiZi","https://ap.wps.com/l/cbCaifK7Ze4MJiZi","pdf",542229,"English","# Introduction\n## Current perioperative standard and limitations\n## Emerging immunotherapy evidence\n## Future directions and biomarker-driven therapy","[{\"question\":\"What is the current standard perioperative chemotherapy for resectable gastric cancer?\",\"answer\":\"Perioperative fluorouracil, leucovorin, oxaliplatin, and docetaxel is described as the current standard based on FLOT4 and ESOPEC trials.\"},{\"question\":\"Why is there interest in perioperative immunotherapy?\",\"answer\":\"Complete response rates with perioperative chemotherapy remain below about 10%–15%, indicating unmet need for more effective regimens.\"},{\"question\":\"Which perioperative immunotherapy trials are highlighted, and what outcomes are reported?\",\"answer\":\"KEYNOTE-585 with pembrolizumab and MATTERHORN with durvalumab are highlighted, showing promising improvements in response rates and event-free survival, though not yet standard of care.\"}]","Perioperative immunotherapy in gastric cancer in the spotlight - MINIREVIEWS | PDF",1790564374,38]