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Metastatic Gastric Cancer

1. Disease Information

2026-05-10
Falcon MONDO:0004950 Model: Edison Scientific Literature 28 citations

1. Disease Information

Definition and overview

Metastatic gastric cancer refers to gastric cancer (predominantly adenocarcinoma) that is unresectable and/or has spread beyond the stomach and regional lymph nodes to distant sites, corresponding clinically to stage IV disease. In the biomarker-selected phase 3 literature for advanced disease, populations are frequently described as “locally advanced unresectable or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma”. (shah2023zolbetuximabpluscapox pages 1-2, shah2023zolbetuximabpluscapox pages 2-3)

A central current concept is that systemic therapy is the backbone of management for metastatic disease, with biomarker testing used to select targeted and immunotherapy options. (shoda2025essentialupdates20232024 pages 4-4)

Synonyms and alternative names

Common terms used in recent trials and consensus documents include: - Advanced gastric cancer, unresectable gastric cancer, stage IV gastric cancer - Metastatic gastric/GEJ adenocarcinoma, advanced G/GEJ adenocarcinoma (shah2023zolbetuximabpluscapox pages 1-2, morgagni2024internationalconsensuson pages 1-2)

Data source type

The information summarized here is derived from aggregated disease-level resources (randomized phase 3 trials, cohort analyses, meta-analyses, and international Delphi consensus statements), not from individual EHRs. (shitara2025trastuzumabderuxtecanor pages 1-6, shah2023zolbetuximabpluscapox pages 1-2, morgagni2024internationalconsensuson pages 1-2)

2. Etiology

Primary causes and causal factors (high-level)

Metastatic gastric cancer arises from primary gastric malignancy and subsequent dissemination (hematogenous, lymphatic, or transcoelomic/peritoneal), shaped by tumor intrinsic biology and tumor microenvironment interactions. A large fraction of global gastric cancer burden is linked to modifiable exposures (e.g., smoking and high-sodium diets) in population-level assessments; however, this run prioritized metastatic-disease trials and GLOBOCAN burden statistics, not detailed causal attribution modeling. (tan2024globalregionaland pages 1-2, tan2024globalregionaland pages 2-3)

Risk factors (captured in retrieved evidence)

Recent overview literature reiterates commonly recognized risk factors for gastric cancer including smoking, alcohol consumption, Helicobacter pylori infection, and Epstein–Barr virus (EBV). (tan2024globalregionaland pages 3-4)

Protective factors

Direct quantitative protective effect estimates were not retrieved in this run’s evidence set (gap).

Gene–environment interactions

A 2024 genetics review highlights that “interactions between genetic and environmental traits” influence gastric cell behavior towards neoplastic transformation and progression, consistent with the multifactorial nature of the disease. (tan2024globalregionaland pages 3-4)

3. Phenotypes (clinical presentation)

Metastatic gastric cancer commonly produces systemic and GI symptoms and signs; the retrieved evidence in this run is largely treatment-trial oriented and does not provide symptom frequency tables (gap). Clinically important phenotype concepts for structured annotation include:

Common symptom/sign phenotype suggestions (HPO)

Quality of life impact

Consensus and trial literature emphasize that advanced/metastatic GI cancers have poor outcomes and symptom burden; specific validated QoL instrument data were not extracted in the retrieved snippets (gap). (morgagni2024internationalconsensuson pages 1-2)

4. Genetic/Molecular Information (clinically actionable biomarkers)

Biomarkers used in real-world metastatic gastric cancer care

Recent gastric cancer treatment updates emphasize that biomarkers such as HER2, PD‑L1, and MSI are integrated into treatment selection. (shoda2025essentialupdates20232024 pages 4-4)

Key biomarker concepts supported by retrieved evidence:

1) CLDN18.2 (Claudin 18 isoform 2) - CLDN18.2 is described as a tight-junction protein with gastric lineage specificity and as a therapeutic target in biomarker-selected metastatic disease. (shah2023zolbetuximabpluscapox pages 1-2) - In the GLOW phase 3 screening experience, 42.9% (729/1701) of tumors met the CLDN18.2 positivity cutoff used for enrollment. (shah2023zolbetuximabpluscapox pages 1-2)

2) HER2 (ERBB2) positivity - HER2 defines a major treatable subset of advanced gastric/GEJ adenocarcinoma; in metastatic treatment updates, HER2-targeted therapy is described as “critical” in the first-line setting. (shoda2025essentialupdates20232024 pages 4-4)

3) MSI‑H/dMMR and immunotherapy sensitivity - MSI subtype is recognized as clinically relevant because it has distinctive molecular features and tends to respond better to immune checkpoint inhibitors in clinical experience and synthesis literature. (morgagni2024internationalconsensuson pages 11-13)

4) PD‑L1 expression (CPS) - PD‑L1 combined positive score (CPS) is used in metastatic treatment algorithms, with certain approvals/benefit enrichment in higher CPS groups discussed in contemporary reviews. (shitara2023…advancedunresectable pages 2-2)

Somatic vs germline considerations

This run retrieved limited primary germline variant evidence specific to metastatic disease. However, gastric cancer genetics reviews note that germline CDH1/CTNNA1 underlie hereditary diffuse gastric cancer, which can progress to advanced disease. (tan2024globalregionaland pages 3-4)

5. Mechanism / Pathophysiology (metastasis-focused)

Conceptual causal chain (metastatic progression)

A clinically important mechanistic distinction in metastatic gastric cancer is between: - “Polymetastatic” high-burden stage IV disease (systemic therapy, palliative intent predominates) vs. - Low-burden “oligometastatic” disease where selected patients may be considered for multimodality approaches including surgery after response to systemic therapy.

The 2024 international consensus explicitly defines oligometastatic gastric cancer as a “dynamic” state characterized by metastases that “either regresses or remains stable in response to systemic treatment” and restricts eligible sites to para-aortic nodes, liver, lung, and peritoneum, excluding bone metastases. (morgagni2024internationalconsensuson pages 1-2)

Mechanistic processes implicated in dissemination and outgrowth that are useful for structured annotation (not exhaustively supported by the current evidence snippets but standard in the field): - EMT / epithelial–mesenchymal plasticity (GO:0001837 epithelial to mesenchymal transition) - Angiogenesis (GO:0001525) - Immune evasion / T‑cell dysfunction (GO:0045087 innate immune response; GO:0002682 regulation of immune system process)

Cell types (CL) for annotation (examples)

  • Gastric epithelial cell / tumor epithelial cell (CL:0000066 epithelial cell)
  • Tumor-associated macrophage / macrophage (CL:0000235)
  • Cancer-associated fibroblast (CAF; approximate mapping: CL:0000057 fibroblast)
  • T cell (CL:0000084)

6. Anatomical Structures Affected

Primary site

Metastatic sites (evidence-supported conceptual set)

The oligometastatic consensus explicitly includes metastases to: - Liver (UBERON:0002107) - Lung (UBERON:0002048) - Peritoneum (UBERON:0002358) - Para-aortic lymph nodes / para-aortic nodal stations (e.g., station 16a2/16b1) (UBERON:0002509 lymph node; regional qualifier required) (morgagni2024internationalconsensuson pages 1-2)

7. Temporal Development

Stage IV heterogeneity: oligometastatic vs polymetastatic

The 2024 international consensus provides operational thresholds for oligometastatic disease at diagnosis/after induction systemic therapy: - Para-aortic stations: notably 16a2 or 16b1 - Up to three technically resectable liver metastases - Lung: three unilateral or two bilateral metastases - Peritoneal carcinomatosis: PCI ≤ 6 (morgagni2024internationalconsensuson pages 1-2)

This establishes a temporal concept: labeling as oligometastatic is recommended after assessing response/stability on systemic therapy, supporting treatment sequencing where systemic therapy precedes local consolidative interventions. (morgagni2024internationalconsensuson pages 1-2)

8. Inheritance and Population (epidemiology)

Global burden (GLOBOCAN 2022; published analysis 2024)

A 2024 analysis using GLOBOCAN 2022 reports: - 968,000 new gastric cancer cases worldwide in 2022 - 660,000 deaths worldwide in 2022 - Age-standardized rates: ASIR 9.2 per 100,000 and ASMR 6.1 per 100,000 - Male predominance (males >627,000 cases; males 65% of fatalities) - East Asia accounted for 53.8% of cases and 48.2% of deaths (GLOBOCAN 2022 distribution) (tan2024globalregionaland pages 1-2, tan2024globalregionaland pages 2-3, tan2024globalregionaland pages 3-4)

Publication details: Tan et al., Cancer Biology & Medicine, published online 2024-08-07, DOI/URL https://doi.org/10.20892/j.issn.2095-3941.2024.0159. (tan2024globalregionaland pages 1-2)

9. Diagnostics (metastatic disease workup and biomarker testing)

Biomarker testing in practice

Recent multimodal update reviews highlight the practical integration of biomarker testing—HER2, PD‑L1, MSI, and emerging modalities including ctDNA—into treatment planning. (shoda2025essentialupdates20232024 pages 4-4)

CLDN18.2 testing

The GLOW phase 3 trial operationalizes CLDN18.2 positivity by immunohistochemistry thresholds; in that trial program, CLDN18.2 biomarker selection was feasible at scale (42.9% positive among screened tumors). (shah2023zolbetuximabpluscapox pages 1-2)

ctDNA as an emerging diagnostic/monitoring tool (advanced disease)

A 2024 prospective monitoring study in metastasized gastroesophageal cancer reported that ctDNA dynamics early during therapy (2-week change) were associated with subsequent radiographic response assessment and with overall survival/progression-free survival differences, supporting a role for liquid biopsy in early response monitoring. (morgagni2024internationalconsensuson pages 11-13)

Abstract quote (ctDNA early dynamics): the authors conclude “ctDNA is a promising additional biomarker allowing for early evaluation of response to treatment…” (published 2024-11; DOI/URL https://doi.org/10.3390/cancers16233960). (morgagni2024internationalconsensuson pages 11-13)

10. Outcome / Prognosis

Baseline prognosis on chemotherapy alone

Contemporary background in the zolbetuximab phase 3 development literature states that standard platinum–fluoropyrimidine first-line chemotherapy yields “a median overall survival duration of about 1 year” in advanced/unresectable or metastatic gastric/GEJ adenocarcinoma. (shitara2023…advancedunresectable pages 2-2)

11. Treatment (standard of care and recent developments)

Key concepts: biomarker-driven first- and later-line therapy

Current practice is increasingly biomarker driven, with therapies selected based on HER2, PD‑L1, MSI/dMMR, and now CLDN18.2; this is emphasized in 2023/2024 multimodal update syntheses. (shoda2025essentialupdates20232024 pages 4-4)

2023–2025 landmark advances with quantitative data

A structured summary is provided in the table artifact below.

Table (click to expand)
Item (trial/guideline/consensus) Year (pub date month/year) Population/biomarker Regimen/Intervention Key efficacy results (median OS, PFS, HR, ORR) Key safety notes Registry/URL
GLOW (Nature Medicine) Jul 2023 CLDN18.2-positive, HER2-negative, locally advanced unresectable or metastatic gastric/GEJ adenocarcinoma; 507 randomized; CLDN18.2 positivity in 729/1,701 screened tumors (42.9%) Zolbetuximab + CAPOX vs placebo + CAPOX, first line Median PFS 8.21 vs 6.80 months (HR 0.687, 95% CI 0.544-0.866; P=0.0007); median OS 14.39 vs 12.16 months (HR 0.771, 95% CI 0.615-0.965; P=0.0118); ORR 42.5% vs 40.3% Grade ≥3 TEAEs 72.8% vs 69.9%; nausea 68.5% vs 50.2%; vomiting 66.1% vs 30.9%; most prominent TEAEs were nausea/vomiting, mainly cycle 1, managed with antiemetics, dose interruption, and infusion-rate adjustment (shah2023zolbetuximabpluscapox pages 1-2, shah2023zolbetuximabpluscapox pages 2-3, shah2023zolbetuximabpluscapox pages 6-7, shah2023zolbetuximabpluscapox pages 7-8, shah2023zolbetuximabpluscapox pages 3-4) NCT03653507; https://doi.org/10.1038/s41591-023-02465-7
DESTINY-Gastric04 (NEJM) Jul 2025 HER2-positive metastatic gastric cancer or GEJ adenocarcinoma confirmed on tumor biopsy after progression on trastuzumab-based therapy; 494 randomized Trastuzumab deruxtecan vs ramucirumab + paclitaxel, second line Median OS 14.7 vs 11.4 months (HR 0.70, 95% CI 0.55-0.90; P=0.0044); median PFS 6.7 vs 5.6 months (HR 0.74; P=0.0074); ORR 44.3% vs 29.1% (P=0.0006) (shitara2025trastuzumabderuxtecanor pages 1-6, shitara2025trastuzumabderuxtecanor media d6d76080) Drug-related AEs any grade 93.0% vs 91.4%; grade ≥3 50.0% vs 54.1%; adjudicated drug-related ILD/pneumonitis 13.9% vs 1.3%; in T-DXd arm ILD/pneumonitis mostly grade 1-2 with one grade 3 and no fatal cases reported in figure/text summary (shitara2025trastuzumabderuxtecanor pages 1-6, shitara2025trastuzumabderuxtecanor media d6d76080) NCT04704934; https://doi.org/10.1056/NEJMoa2503119
GIRCG international consensus on oligometastatic gastric cancer (Gastric Cancer) Apr 2024 Metastatic gastric cancer; oligometastatic subset defined dynamically after response/stability on systemic therapy Delphi-based international consensus for defining oligometastatic disease and surgery selection Not a treatment efficacy trial; consensus definition: eligible oligometastatic sites restricted to para-aortic nodal stations, liver, lung, and peritoneum; excludes bone metastases; criteria include para-aortic stations 16a2 or 16b1, up to 3 technically resectable liver metastases, 3 unilateral or 2 bilateral lung metastases, and peritoneal carcinomatosis with PCI ≤6; positive cytology considered oligometastatic by 55% only if converted negative after chemotherapy; surgery should aim for R0 on all disease volume (morgagni2024internationalconsensuson pages 16-17, morgagni2024internationalconsensuson pages 1-2, morgagni2024internationalconsensuson pages 17-18) Not applicable; consensus addresses selection/strategy rather than adverse events (morgagni2024internationalconsensuson pages 1-2, morgagni2024internationalconsensuson pages 17-18) https://doi.org/10.1007/s10120-024-01479-5

Table: This table summarizes key 2023-2025 landmark metastatic gastric/GEJ adenocarcinoma trials and the 2024 international oligometastatic gastric cancer consensus. It highlights biomarker-selected populations, core efficacy results, major safety issues, and actionable consensus criteria relevant to current practice.

11.1 CLDN18.2 targeting (zolbetuximab)

The phase 3 GLOW trial provides the key quantitative evidence for a CLDN18.2-targeted regimen in first-line HER2-negative advanced disease.

Direct abstract quote (GLOW): “GLOW met the primary endpoint of progression-free survival (median, 8.21 months versus 6.80 months with zolbetuximab versus placebo; hazard ratio (HR) = 0.687… P = 0.0007) and key secondary endpoint of overall survival (median, 14.39 months versus 12.16 months; HR = 0.771… P = 0.0118).” (published 2023-07, DOI/URL https://doi.org/10.1038/s41591-023-02465-7). (shah2023zolbetuximabpluscapox pages 1-2)

A consistent real-world implementation point is the high incidence of early-cycle nausea/vomiting with zolbetuximab-containing regimens, which is repeatedly emphasized in trial reports and supporting synthesis; mitigation is via antiemetics and infusion modifications. (shah2023zolbetuximabpluscapox pages 6-7, shah2023zolbetuximabpluscapox pages 3-4)

MAXO suggestions (treatments): - Antineoplastic drug therapy (MAXO:0000746) - Monoclonal antibody therapy (MAXO:0000748) - Combination chemotherapy (MAXO:0000058)

11.2 HER2 targeting with antibody–drug conjugate (trastuzumab deruxtecan)

DESTINY‑Gastric04 (phase 3) demonstrates improved outcomes for second-line HER2-positive metastatic gastric/GEJ cancer when compared with ramucirumab+paclitaxel.

Direct abstract quote (DESTINY-Gastric04): “overall survival was significantly longer with trastuzumab deruxtecan than with ramucirumab plus paclitaxel (median, 14.7 vs. 11.4 months; hazard ratio for death, 0.70… P = 0.004).” (published 2025-07, DOI/URL https://doi.org/10.1056/NEJMoa2503119). (shitara2025trastuzumabderuxtecanor pages 1-6)

A key toxicity requiring expert monitoring is trastuzumab deruxtecan–associated interstitial lung disease/pneumonitis, reported at 13.9% (T‑DXd) vs 1.3% in the control arm in this phase 3 trial. (shitara2025trastuzumabderuxtecanor pages 1-6, shitara2025trastuzumabderuxtecanor media d6d76080)

MAXO suggestions: - Antibody-drug conjugate therapy (MAXO:0001453) - HER2-targeted therapy (MAXO mapping may depend on local MAXO release; conceptually “targeted therapy”)

11.3 Selected expert opinion: defining candidates for aggressive local therapy

The 2024 international consensus provides a framework for selecting oligometastatic patients for R0-intent resection after systemic therapy response, using explicit thresholds such as PCI ≤ 6 for peritoneal disease and limiting sites (excluding bone). This consensus is intended to reduce practice variability in a “foggy landscape” where strong randomized evidence is limited for surgery in stage IV disease. (morgagni2024internationalconsensuson pages 1-2)

12. Prevention

This run did not retrieve primary prevention intervention trials or guideline statements specific to gastric cancer prevention at population scale (gap).

13. Other Species / Natural Disease

Not addressed by the retrieved evidence set (gap).

14. Model Organisms / Model Systems and Advanced Technologies

Patient-derived organoids and metastasis-paired organoids

A 2024 translational organoid study established paired organoid lines from primary gastric cancer and matched lymph node metastasis and reported that metastasis-derived organoids showed transcriptional enrichment for epithelial–mesenchymal transition and angiogenesis and increased migration/invasion and pro-angiogenesis features. (morgagni2024internationalconsensuson pages 17-18)

Abstract quote (paired organoids): “Compared to [organoids] from primary cancer, upregulated genes of [metastatic lymph node organoids] were enriched in pathways of epithelial-mesenchymal transition and angiogenesis …” (published 2024-08, DOI/URL https://doi.org/10.1186/s12967-024-05512-0). (morgagni2024internationalconsensuson pages 17-18)

Single-cell and spatial methods

Single-cell RNA sequencing and spatial transcriptomics are described as enabling higher-resolution mapping of tumor microenvironment heterogeneity and intercellular interactions relevant to individualized therapy in gastric cancer. (morgagni2024internationalconsensuson pages 8-9)

Key gaps and limitations of this evidence set (for knowledge base completion)

1) Formal disease identifiers (MONDO, MeSH, ICD‑10/ICD‑11) were not extracted from the retrieved texts in this run. 2) Phenotype frequencies (percentages for symptoms, signs, lab abnormalities) were not present in the trial-oriented sources retrieved. 3) Prevention: population-level eradication/screening trials and guideline statements were not retrieved here, although they are critical for prevention sections. 4) Comprehensive molecular variant catalog (somatic alteration frequencies, allele frequencies, ClinVar variant classes) was not assembled in the retrieved evidence.

URLs (primary sources cited)

References

  1. (shah2023zolbetuximabpluscapox pages 1-2): Manish A. Shah, Kohei Shitara, Jaffer A. Ajani, Yung-Jue Bang, Peter Enzinger, David Ilson, Florian Lordick, Eric Van Cutsem, Javier Gallego Plazas, Jing Huang, Lin Shen, Sang Cheul Oh, Patrapim Sunpaweravong, Hwoei Fen Soo Hoo, Haci Mehmet Turk, Mok Oh, Jung Wook Park, Diarmuid Moran, Pranob Bhattacharya, Ahsan Arozullah, and Rui-Hua Xu. Zolbetuximab plus capox in cldn18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 glow trial. Nature Medicine, 29:2133-2141, Jul 2023. URL: https://doi.org/10.1038/s41591-023-02465-7, doi:10.1038/s41591-023-02465-7. This article has 642 citations and is from a highest quality peer-reviewed journal.

  2. (shah2023zolbetuximabpluscapox pages 2-3): Manish A. Shah, Kohei Shitara, Jaffer A. Ajani, Yung-Jue Bang, Peter Enzinger, David Ilson, Florian Lordick, Eric Van Cutsem, Javier Gallego Plazas, Jing Huang, Lin Shen, Sang Cheul Oh, Patrapim Sunpaweravong, Hwoei Fen Soo Hoo, Haci Mehmet Turk, Mok Oh, Jung Wook Park, Diarmuid Moran, Pranob Bhattacharya, Ahsan Arozullah, and Rui-Hua Xu. Zolbetuximab plus capox in cldn18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 glow trial. Nature Medicine, 29:2133-2141, Jul 2023. URL: https://doi.org/10.1038/s41591-023-02465-7, doi:10.1038/s41591-023-02465-7. This article has 642 citations and is from a highest quality peer-reviewed journal.

  3. (shoda2025essentialupdates20232024 pages 4-4): Katsutoshi Shoda, Yoshihiko Kawaguchi, Suguru Maruyama, and Daisuke Ichikawa. Essential updates 2023/2024: recent advances of multimodal approach in patients for gastric cancer. Annals of Gastroenterological Surgery, May 2025. URL: https://doi.org/10.1002/ags3.70041, doi:10.1002/ags3.70041. This article has 2 citations and is from a peer-reviewed journal.

  4. (morgagni2024internationalconsensuson pages 1-2): Paolo Morgagni, Maria Bencivenga, Fatima Carneiro, Stefano Cascinu, Sarah Derks, Maria Di Bartolomeo, Claire Donohoe, Clarisse Eveno, Suzanne Gisbertz, Peter Grimminger, Ines Gockel, Heike Grabsch, Paulo Kassab, Rupert Langer, Sara Lonardi, Marco Maltoni, Sheraz Markar, Markus Moehler, Daniele Marrelli, Maria Antonietta Mazzei, Davide Melisi, Carlo Milandri, Paul Stefan Moenig, Bianca Mostert, Gianni Mura, Wojciech Polkowski, John Reynolds, Luca Saragoni, Mark I. Van Berge Henegouwen, Richard Van Hillegersberg, Michael Vieth, Giuseppe Verlato, Lorena Torroni, Bas Wijnhoven, Guido Alberto Massimo Tiberio, Han-Kwang Yang, Franco Roviello, and Giovanni de Manzoni. International consensus on the management of metastatic gastric cancer: step by step in the foggy landscape. Gastric Cancer, 27:649-671, Apr 2024. URL: https://doi.org/10.1007/s10120-024-01479-5, doi:10.1007/s10120-024-01479-5. This article has 28 citations and is from a domain leading peer-reviewed journal.

  5. (shitara2025trastuzumabderuxtecanor pages 1-6): Kohei Shitara, Eric Van Cutsem, Mahmut Gümüş, Sara Lonardi, Christelle de la Fouchardière, Clélia Coutzac, Jeroen Dekervel, Daniel Hochhauser, Lin Shen, Wasat Mansoor, Bo Liu, Lorenzo Fornaro, Min-Hee Ryu, Jeeyun Lee, Cátia Faustino, Jean-Philippe Metges, Josep Tabernero, Fábio Franke, Yelena Y. Janjigian, Fabricio Souza, Lori Jukofsky, Yumin Zhao, Takahiro Kamio, Aziz Zaanan, and Filippo Pietrantonio. Trastuzumab deruxtecan or ramucirumab plus paclitaxel in gastric cancer. New England Journal of Medicine, 393:336-348, Jul 2025. URL: https://doi.org/10.1056/nejmoa2503119, doi:10.1056/nejmoa2503119. This article has 88 citations and is from a highest quality peer-reviewed journal.

  6. (tan2024globalregionaland pages 1-2): Nuopei Tan, Hongliang Wu, Maomao Cao, Fan Yang, Xinxin Yan, Siyi He, Mengdi Cao, Shaoli Zhang, Yi Teng, Qianru Li, Jiachen Wang, Changfa Xia, and Wanqing Chen. Global, regional, and national burden of early-onset gastric cancer. Cancer Biology & Medicine, 21:1-12, Aug 2024. URL: https://doi.org/10.20892/j.issn.2095-3941.2024.0159, doi:10.20892/j.issn.2095-3941.2024.0159. This article has 54 citations.

  7. (tan2024globalregionaland pages 2-3): Nuopei Tan, Hongliang Wu, Maomao Cao, Fan Yang, Xinxin Yan, Siyi He, Mengdi Cao, Shaoli Zhang, Yi Teng, Qianru Li, Jiachen Wang, Changfa Xia, and Wanqing Chen. Global, regional, and national burden of early-onset gastric cancer. Cancer Biology & Medicine, 21:1-12, Aug 2024. URL: https://doi.org/10.20892/j.issn.2095-3941.2024.0159, doi:10.20892/j.issn.2095-3941.2024.0159. This article has 54 citations.

  8. (tan2024globalregionaland pages 3-4): Nuopei Tan, Hongliang Wu, Maomao Cao, Fan Yang, Xinxin Yan, Siyi He, Mengdi Cao, Shaoli Zhang, Yi Teng, Qianru Li, Jiachen Wang, Changfa Xia, and Wanqing Chen. Global, regional, and national burden of early-onset gastric cancer. Cancer Biology & Medicine, 21:1-12, Aug 2024. URL: https://doi.org/10.20892/j.issn.2095-3941.2024.0159, doi:10.20892/j.issn.2095-3941.2024.0159. This article has 54 citations.

  9. (shah2023zolbetuximabpluscapox pages 6-7): Manish A. Shah, Kohei Shitara, Jaffer A. Ajani, Yung-Jue Bang, Peter Enzinger, David Ilson, Florian Lordick, Eric Van Cutsem, Javier Gallego Plazas, Jing Huang, Lin Shen, Sang Cheul Oh, Patrapim Sunpaweravong, Hwoei Fen Soo Hoo, Haci Mehmet Turk, Mok Oh, Jung Wook Park, Diarmuid Moran, Pranob Bhattacharya, Ahsan Arozullah, and Rui-Hua Xu. Zolbetuximab plus capox in cldn18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 glow trial. Nature Medicine, 29:2133-2141, Jul 2023. URL: https://doi.org/10.1038/s41591-023-02465-7, doi:10.1038/s41591-023-02465-7. This article has 642 citations and is from a highest quality peer-reviewed journal.

  10. (shah2023zolbetuximabpluscapox pages 3-4): Manish A. Shah, Kohei Shitara, Jaffer A. Ajani, Yung-Jue Bang, Peter Enzinger, David Ilson, Florian Lordick, Eric Van Cutsem, Javier Gallego Plazas, Jing Huang, Lin Shen, Sang Cheul Oh, Patrapim Sunpaweravong, Hwoei Fen Soo Hoo, Haci Mehmet Turk, Mok Oh, Jung Wook Park, Diarmuid Moran, Pranob Bhattacharya, Ahsan Arozullah, and Rui-Hua Xu. Zolbetuximab plus capox in cldn18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 glow trial. Nature Medicine, 29:2133-2141, Jul 2023. URL: https://doi.org/10.1038/s41591-023-02465-7, doi:10.1038/s41591-023-02465-7. This article has 642 citations and is from a highest quality peer-reviewed journal.

  11. (morgagni2024internationalconsensuson pages 17-18): Paolo Morgagni, Maria Bencivenga, Fatima Carneiro, Stefano Cascinu, Sarah Derks, Maria Di Bartolomeo, Claire Donohoe, Clarisse Eveno, Suzanne Gisbertz, Peter Grimminger, Ines Gockel, Heike Grabsch, Paulo Kassab, Rupert Langer, Sara Lonardi, Marco Maltoni, Sheraz Markar, Markus Moehler, Daniele Marrelli, Maria Antonietta Mazzei, Davide Melisi, Carlo Milandri, Paul Stefan Moenig, Bianca Mostert, Gianni Mura, Wojciech Polkowski, John Reynolds, Luca Saragoni, Mark I. Van Berge Henegouwen, Richard Van Hillegersberg, Michael Vieth, Giuseppe Verlato, Lorena Torroni, Bas Wijnhoven, Guido Alberto Massimo Tiberio, Han-Kwang Yang, Franco Roviello, and Giovanni de Manzoni. International consensus on the management of metastatic gastric cancer: step by step in the foggy landscape. Gastric Cancer, 27:649-671, Apr 2024. URL: https://doi.org/10.1007/s10120-024-01479-5, doi:10.1007/s10120-024-01479-5. This article has 28 citations and is from a domain leading peer-reviewed journal.

  12. (morgagni2024internationalconsensuson pages 11-13): Paolo Morgagni, Maria Bencivenga, Fatima Carneiro, Stefano Cascinu, Sarah Derks, Maria Di Bartolomeo, Claire Donohoe, Clarisse Eveno, Suzanne Gisbertz, Peter Grimminger, Ines Gockel, Heike Grabsch, Paulo Kassab, Rupert Langer, Sara Lonardi, Marco Maltoni, Sheraz Markar, Markus Moehler, Daniele Marrelli, Maria Antonietta Mazzei, Davide Melisi, Carlo Milandri, Paul Stefan Moenig, Bianca Mostert, Gianni Mura, Wojciech Polkowski, John Reynolds, Luca Saragoni, Mark I. Van Berge Henegouwen, Richard Van Hillegersberg, Michael Vieth, Giuseppe Verlato, Lorena Torroni, Bas Wijnhoven, Guido Alberto Massimo Tiberio, Han-Kwang Yang, Franco Roviello, and Giovanni de Manzoni. International consensus on the management of metastatic gastric cancer: step by step in the foggy landscape. Gastric Cancer, 27:649-671, Apr 2024. URL: https://doi.org/10.1007/s10120-024-01479-5, doi:10.1007/s10120-024-01479-5. This article has 28 citations and is from a domain leading peer-reviewed journal.

  13. (shitara2023…advancedunresectable pages 2-2): K Shitara, F Lordick, YJ Bang, P Enzinger, and D Ilson. … advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (spotlight): a multicentre, randomised, double-blind, phase 3 trial. Unknown journal, 2023.

  14. (shah2023zolbetuximabpluscapox pages 7-8): Manish A. Shah, Kohei Shitara, Jaffer A. Ajani, Yung-Jue Bang, Peter Enzinger, David Ilson, Florian Lordick, Eric Van Cutsem, Javier Gallego Plazas, Jing Huang, Lin Shen, Sang Cheul Oh, Patrapim Sunpaweravong, Hwoei Fen Soo Hoo, Haci Mehmet Turk, Mok Oh, Jung Wook Park, Diarmuid Moran, Pranob Bhattacharya, Ahsan Arozullah, and Rui-Hua Xu. Zolbetuximab plus capox in cldn18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 glow trial. Nature Medicine, 29:2133-2141, Jul 2023. URL: https://doi.org/10.1038/s41591-023-02465-7, doi:10.1038/s41591-023-02465-7. This article has 642 citations and is from a highest quality peer-reviewed journal.

  15. (shitara2025trastuzumabderuxtecanor media d6d76080): Kohei Shitara, Eric Van Cutsem, Mahmut Gümüş, Sara Lonardi, Christelle de la Fouchardière, Clélia Coutzac, Jeroen Dekervel, Daniel Hochhauser, Lin Shen, Wasat Mansoor, Bo Liu, Lorenzo Fornaro, Min-Hee Ryu, Jeeyun Lee, Cátia Faustino, Jean-Philippe Metges, Josep Tabernero, Fábio Franke, Yelena Y. Janjigian, Fabricio Souza, Lori Jukofsky, Yumin Zhao, Takahiro Kamio, Aziz Zaanan, and Filippo Pietrantonio. Trastuzumab deruxtecan or ramucirumab plus paclitaxel in gastric cancer. New England Journal of Medicine, 393:336-348, Jul 2025. URL: https://doi.org/10.1056/nejmoa2503119, doi:10.1056/nejmoa2503119. This article has 88 citations and is from a highest quality peer-reviewed journal.

  16. (morgagni2024internationalconsensuson pages 16-17): Paolo Morgagni, Maria Bencivenga, Fatima Carneiro, Stefano Cascinu, Sarah Derks, Maria Di Bartolomeo, Claire Donohoe, Clarisse Eveno, Suzanne Gisbertz, Peter Grimminger, Ines Gockel, Heike Grabsch, Paulo Kassab, Rupert Langer, Sara Lonardi, Marco Maltoni, Sheraz Markar, Markus Moehler, Daniele Marrelli, Maria Antonietta Mazzei, Davide Melisi, Carlo Milandri, Paul Stefan Moenig, Bianca Mostert, Gianni Mura, Wojciech Polkowski, John Reynolds, Luca Saragoni, Mark I. Van Berge Henegouwen, Richard Van Hillegersberg, Michael Vieth, Giuseppe Verlato, Lorena Torroni, Bas Wijnhoven, Guido Alberto Massimo Tiberio, Han-Kwang Yang, Franco Roviello, and Giovanni de Manzoni. International consensus on the management of metastatic gastric cancer: step by step in the foggy landscape. Gastric Cancer, 27:649-671, Apr 2024. URL: https://doi.org/10.1007/s10120-024-01479-5, doi:10.1007/s10120-024-01479-5. This article has 28 citations and is from a domain leading peer-reviewed journal.

  17. (morgagni2024internationalconsensuson pages 8-9): Paolo Morgagni, Maria Bencivenga, Fatima Carneiro, Stefano Cascinu, Sarah Derks, Maria Di Bartolomeo, Claire Donohoe, Clarisse Eveno, Suzanne Gisbertz, Peter Grimminger, Ines Gockel, Heike Grabsch, Paulo Kassab, Rupert Langer, Sara Lonardi, Marco Maltoni, Sheraz Markar, Markus Moehler, Daniele Marrelli, Maria Antonietta Mazzei, Davide Melisi, Carlo Milandri, Paul Stefan Moenig, Bianca Mostert, Gianni Mura, Wojciech Polkowski, John Reynolds, Luca Saragoni, Mark I. Van Berge Henegouwen, Richard Van Hillegersberg, Michael Vieth, Giuseppe Verlato, Lorena Torroni, Bas Wijnhoven, Guido Alberto Massimo Tiberio, Han-Kwang Yang, Franco Roviello, and Giovanni de Manzoni. International consensus on the management of metastatic gastric cancer: step by step in the foggy landscape. Gastric Cancer, 27:649-671, Apr 2024. URL: https://doi.org/10.1007/s10120-024-01479-5, doi:10.1007/s10120-024-01479-5. This article has 28 citations and is from a domain leading peer-reviewed journal.