For decades, chemotherapy, surgery, and radiotherapy were the only options for stomach cancer management. While these approaches have saved countless lives, they come with severe side effects and limitations, including resistance to treatment and high recurrence rates.
Advances in medical research have brought a new era of cancer treatment. Targeted therapy, in particular, is a more precise and personalized option that focuses on specific molecules and pathways driving malignant (cancerous) growth. It has become a sought-after alternative for managing stomach cancer since it attacks the root causes of tumor development, minimizes harm to healthy cells, and improves patient outcomes.
If you’re interested to learn more, read on for a deep dive into targeted therapy’s role in stomach cancer treatment. We’ll discuss how these therapies work, their benefits, current challenges, and how targeted therapy is leading us toward more effective and less invasive cancer treatments.
What Is Stomach Cancer?
Stomach cancer, also synonymous with gastric cancer, is a result of abnormal cells forming and multiplying in the stomach’s lining. It has several types, with adenocarcinoma accounting for 95% of all stomach cancer cases. Other less common forms include gastrointestinal stromal tumors (GISTs), lymphomas, and carcinoid tumors.
Gastric cancer can develop in various regions of the stomach. Over time, it can spread to nearby lymph nodes, organs, or distant parts of the body. Its progression depends on the stage of the disease at diagnosis, which ranges from localized to advanced metastatic cancer.
What Are the Challenges in Treating Stomach Cancer?
Gastric cancer is one of the most difficult to catch early due to its tendency to progress silently or vaguely. Symptoms like indigestion, bloating, and stomach discomfort often mimic less serious conditions, delaying detection.
Conventional treatments, including surgery, chemo, and radiotherapy, have helped millions of people manage stomach cancer. However, these methods come with drawbacks. Chemotherapy and radiation therapy often cause debilitating side effects, including persistent fatigue, hair loss, pain, nerve damage, and immune suppression. Some tumors also develop resistance to these treatments, limiting their long-term effectiveness.
Is Stomach Cancer Still a Leading Cause of Cancer-Related Deaths?
Up until the 1980s, stomach cancer was the leading cause of death among cancer patients in the United States. As of 2024, lung and bronchus, pancreatic, colorectal, and breast cancers have replaced it, and the number of new cases is also dropping.
The reasons for this decline are not completely clear. Still, experts think that it’s due to the decrease in people infected with the Helicobacter pylori bacteria—an established cause of stomach cancer in the early 20th century. Moreover, most people nowadays use refrigerators instead of methods like salting and smoking (one of the known risk factors for stomach cancer) to preserve food.
Nonetheless, stomach cancer is still a global health problem. It remains the fifth leading cancer and one of the top ten most common causes of cancer-related deaths worldwide. According to the American Cancer Society, it accounts for about 1.5% of all new cancer cases in the U.S. On a global scale, it’s responsible for 1.1 million new cases annually. Therefore, the general population must still be aware of this disease and its treatment options.
Introduction to Targeted Therapy
Targeted therapy is a revolutionary approach to treating cancer. As mentioned earlier, it works by zeroing in on the molecules and pathways contributing to tumor growth. Unlike traditional or conventional chemotherapy, which broadly attacks rapidly dividing cells, targeted therapy hones in on precise genetic, protein, or molecular changes that help cancer cells thrive. This precision allows doctors to treat cancer with fewer side effects, preserving the patient’s healthy cells and improving their quality of life.
Researchers have identified several drivers of cancer, including genetic mutations, receptor overexpression, and dysregulated signaling pathways. Targeted therapy disrupts these drivers by using drugs designed to interfere with cancer’s growth mechanisms. For example, monoclonal antibodies bind to cancer-specific proteins, blocking their function or flagging the cells for immune destruction. Tyrosine kinase inhibitors (TKIs) block enzymes critical to cancer cell proliferation, while anti-angiogenesis drugs prevent tumors from forming blood vessels needed for growth. Immune checkpoint inhibitors unleash the body’s immune system to identify and destroy cancer cells more effectively.
The field of targeted therapy has grown rapidly in recent years. It offers new hope for patients with hard-to-treat cancers like stomach cancer. Each treatment is personalized to the molecular characteristics of a tumor, ensuring precision oncology and better outcomes. Though not every patient qualifies for these therapies, advances in biomarker testing and drug development continue to expand access.
Targeted Therapy for Stomach Cancer: How It Works
Targeted therapy disrupts specific biological processes that drive tumor growth in the stomach. Researchers have discovered several molecular targets in gastric cancer.
Drugs That Targets HER2 in Stomach Cancer
Some stomach cancers exhibit an overproduction of the HER2 protein, which stimulates rapid cell growth and tumor progression. These cancers, classified as HER2-positive, respond well to therapies targeting this specific protein. Treatments designed to inhibit HER2 activity in
Trastuzumab (Herceptin and Biosimilars)
Trastuzumab is a monoclonal antibody that targets HER2-positive cancer cells. It binds to the HER2 protein on these cells, blocks growth signals, and signals the immune system to destroy them. Used alongside chemotherapy, trastuzumab has extended survival rates for many individuals with advanced HER2-positive stomach cancer.
Before initiating treatment, doctors conduct HER2 testing on tumor samples to ensure the cancer qualifies for this therapy. Trastuzumab is administered intravenously, typically every two or three weeks, in combination with chemotherapy.
Several biosimilar versions of trastuzumab are now available, including Ogivri, Herzuma, Ontruzant, Trazimera, and Kanjinti.
Side Effects of Trastuzumab
Trastuzumab is generally well-tolerated, with mild side effects such as chills, fever, nausea, weakness, diarrhea, vomiting, and headache. In rare cases, this drug may cause heart-related complications, particularly when combined with anthracycline chemotherapy. To reduce risks, doctors may assess heart function with an echocardiogram or MUGA scan before starting treatment.
Fam-Trastuzumab Deruxtecan (Enhertu)
Fam-trastuzumab deruxtecan is an antibody-drug conjugate (ADC) that combines a HER2-targeting monoclonal antibody with a chemotherapy agent. The antibody serves as a homing signal by attaching to the HER2 protein on cancer cells, delivering chemotherapy directly to the tumor site. This precision reduces damage to healthy cells and enhances effectiveness.
Oncologists often use this drug as a second-line treatment for advanced HER2-positive stomach cancer, or for individuals who have not responded to trastuzumab-based therapy. They typically administer it via intravenous infusion every three weeks.
Side Effects of Fam-Trastuzumab Deruxtecan
Common side effects include nausea, fatigue, diarrhea, and low blood cell counts, which can raise the risk of infection and bleeding. Serious lung complications, such as interstitial lung disease, may occur and require immediate medical attention. Heart function tests may also be necessary before starting targeted therapy to check for cardiac issues.
Drugs That Target VEGF in Stomach Cancer
VEGF (vascular endothelial growth factor) promotes angiogenesis or the formation of new blood vessels, and it allows malignant tumors to receive the oxygen and nutrients they need to grow. The following drugs block VEGF activity to deprive tumors of these resources, slowing or stopping growth:
Ramucirumab (Cyramza)
Ramucirumab is a monoclonal antibody. It prevents VEGF from stimulating blood vessel formation, particularly in patients with advanced stomach cancer. Doctors typically prescribe it after chemotherapy has failed. Administered intravenously every two weeks, ramucirumab can work alone or in combination with chemotherapy.
Side Effects of Ramucirumab
Common side effects include headaches, diarrhea, and high blood pressure. Complications such as bleeding, blood clots, or perforations in the stomach or intestines can sometimes occur. These conditions require immediate medical attention, as they may lead to severe infections or necessitate surgical intervention.
TRK Inhibitors for NTRK Gene Mutations
A small subset of stomach cancers involves mutations in NTRK genes. These DNA changes drive cancer cell growth and make TRK proteins a viable target for treatment.
Larotrectinib (Vitrakvi) and Entrectinib (Rozlytrek)
Larotrectinib and entrectinib are oral medications that inhibit TRK proteins. Healthcare providers use them to treat advanced stomach cancers with NTRK mutations when other treatments have stopped working or failed. Taken once or twice daily, these pills have an overall response rate of 75% and 57%.
Side Effects of TRK Inhibitors
Among the common effects include dizziness, fatigue, diarrhea, and nausea. Less frequent but serious side effects can manifest as liver abnormalities, heart problems, or confusion. Regular monitoring assures the safe use of these targeted therapy medications for gastric cancer.
Drugs That Target CLDN18.2 in Stomach Cancer
Claudin 18.2 (CLDN18.2) is a protein found on the surface of epithelial cells in the gastrointestinal tract. When these cells become cancerous, CLDN18.2 often moves to the cell surface, making it an accessible target for therapy.
Zolbetuximab (Vyloy)
Zolbetuximab is a monoclonal antibody that adheres to CLDN18.2 on cancer cells. Doctors use it to attack advanced HER2-negative stomach cancer that overexpresses CLDN18.2. Combined with chemotherapy, zolbetuximab is slowly becoming a first-line treatment for this specific form of cancer. Healthcare providers administer it intravenously every two to three weeks.
Side Effects of Zolbetuximab
Patients may experience nausea, vomiting, diarrhea, and fatigue. Decreased appetite and sensory neuropathy (reduced sensation in fingertips or toes) may also occur. Less common but serious risks include low blood cell counts, abnormal liver tests, and electrolyte imbalances, which require careful monitoring.
Advantages of Targeted Therapy for Stomach Cancer Patients
Targeted therapy is a transformative option for individuals seeking effective and less invasive alternatives to conventional treatments. Its benefits include:
Improved Treatment Precision
Unlike traditional chemo, which attacks cancerous and healthy cells, targeted therapy hones in on specific molecules that fuel cancer growth. This precision reduces collateral damage by sparing healthy tissues and organs. Patients experience fewer treatment-related side effects and maintain a better quality of life during therapy.
Personalized Medicine
Targeted therapies enable doctors to tailor treatment plans based on a patient’s tumor profile. Molecular testing identifies biomarkers such as HER2, VEGF, or CLDN18.2 to help oncologists select therapies that align with the cancer’s specific characteristics. This personalization increases the likelihood of a positive response.
Fewer Side Effects
Patients undergoing targeted therapy often face fewer and less severe side effects compared to those receiving chemotherapy or radiation. Common side effects such as nausea, fatigue, or diarrhea are typically more manageable, which makes treatment less physically taxing. By sparing healthy cells, targeted therapy minimizes the risk of complications like immune suppression or organ damage.
Improved Survival
For many patients, targeted therapies have extended survival rates, especially when used in advanced cases of stomach cancer. Drugs like trastuzumab and ramucirumab, when combined with chemotherapy or used alone, have demonstrated significant success in slowing disease progression and prolonging life.
Overcoming Drug Resistance
Cancer cells can become immune to traditional treatments over time. Targeted therapies address this challenge by disrupting alternative pathways that tumors may use to sustain growth. Researchers continue to develop new drugs, treatments, and combinations to counteract resistance and enhance the effectiveness of existing therapies.
Enhanced Quality of Life
Patients receiving targeted therapies report a better overall treatment experience. With fewer debilitating side effects, individuals can maintain greater physical and emotional well-being. Many targeted therapies also require less frequent administration, which reduces the burden of hospital visits and improves convenience for patients and their caregivers.
A Foundation for Combination Therapies
Targeted therapy lays the groundwork for innovative combination treatments that integrate chemotherapy, immunotherapy, or other modalities. These strategies amplify the effectiveness of each approach while minimizing toxicity, further improving patient outcomes.
Targeted therapy redefines the standard of care for stomach cancer. By offering precision, personalization, and reduced treatment burdens, this approach provides new hope for better outcomes and a higher quality of life for those facing a challenging diagnosis.
Limitations and Challenges of Targeted Therapy in Stomach Cancer
No treatment is perfect. Acknowledging these obstacles can help patients make better decisions about treatment.
Eligibility Constraints
Not all patients with stomach cancer qualify for targeted therapy. These treatments depend on specific molecular markers, such as HER2 overexpression or others. Patients whose tumors lack these markers cannot benefit from these therapies. This limitation emphasizes the importance of comprehensive biomarker testing, which may not always be accessible due to cost or logistical challenges.
Treatment Resistance
As discussed, cancer cells can adapt and develop resistance to treatments, including targeted therapies. Tumors may activate alternative pathways to bypass the drugs’ effects, rendering the treatment less effective. For example, HER2-positive cancers treated with trastuzumab may eventually stop responding, requiring a shift to other therapies or combination strategies.
Limited Scope of Effectiveness
Many targeted therapy drugs work best when combined with other treatments like chemotherapy. While they show promise in extending survival and improving quality of life, they may not achieve complete remission on their own.
Side Effects
Though targeted therapies cause fewer side effects than traditional chemotherapy, they are not without risks, as mentioned earlier. Drugs like trastuzumab can lead to heart conditions, while ramucirumab may cause high blood pressure or gastrointestinal perforations. Immune-related side effects, such as lung inflammation from checkpoint inhibitors, can also pose serious health risks. Close monitoring during treatment is essential to monitor these potential side effects.
High Costs
Targeted therapy can be expensive. The advanced research and technology required to perform these treatments contribute to their high cost. For many patients, the expense creates barriers to access, even when the therapy could provide life-saving benefits. Efforts to expand insurance coverage and support programs remain critical in addressing this challenge.
Ethical and Equity Concerns
Its high costs and limited accessibility raise ethical concerns about equity in cancer care. While these treatments are scientific breakthroughs, not everyone can benefit from them equally. Addressing these disparities demands systemic changes to healthcare policies and funding models.
Variable Access to Biomarker Testing and Therapies
Access to biomarker testing, which determines eligibility for targeted therapy, varies widely depending on geographic location and healthcare infrastructure. Patients in low-resource settings may not have the opportunity to undergo testing or receive the appropriate targeted drugs, which perpetuates disparities in cancer care.
Complex Treatment Protocols
The integration of targeted therapies into treatment regimens requires coordination among multiple specialists and careful timing to achieve the best outcomes. This complexity can strain healthcare systems and lead to delays or suboptimal care if resources are limited.
Why Targeted Therapy Is Worth It
Targeted therapy offers precision and effectiveness that traditional methods cannot match. The approach personalizes care, ensuring treatments align with the unique characteristics of each patient’s cancer. It delivers fewer side effects, promotes longer survival, and promises a better treatment experience. Despite the challenges, these benefits far outweigh the limitations.
This innovative treatment epitomizes the power of modern medicine to turn a devastating diagnosis into a manageable condition. It gives patients new hope, options, and a chance to fight cancer with cutting-edge science.
If you or a loved one has stomach cancer and want to explore targeted therapy, consider New Hope Unlimited. At our facility, we combine experienced oncologists with personalized care to improve survival rates and preserve quality of life. Our team prioritizes your well-being, offering comprehensive support and access to the latest therapies. You deserve the best care available, and we are here to provide it with compassion and excellence. Reach out today to take the next step in your fight against cancer.
