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A narrative review synthesizing evidence across randomized trials and translational studies to distinguish established clinical practice from exploratory strategies in gastric cancer biomarker-directed therapy.
A single case report with clinical narrative describing an unusual metastatic pattern; it raises mechanistic hypotheses and clinical management questions but provides no comparative data, control group, or generalizable evidence.
Network meta-analysis of 36 RCTs with 8925 patients comparing defined treatment classes for resectable locally advanced gastric cancer, with consistent superiority of chemotherapy plus immunotherapy across survival and pathological endpoints, but limited by indirect comparisons and heterogeneous trial populations.
Single-centre retrospective cohort with small advanced-stage subgroups (n=16 per arm) and exploratory analyses; unadjusted PFS benefit for ICIs did not survive adjustment, and authors explicitly state findings are hypothesis-generating rather than confirmatory.
This is a conceptual framework paper proposing a treatment approach for locally advanced gastric cancer, explicitly lacking primary clinical data and validation, presented as a hypothesis-driven concept requiring future prospective testing.
High-quality meta-analysis of 8 phase III RCTs with 7,127 patients showing consistent, statistically significant OS and PFS benefit for ICI-chemotherapy over chemotherapy alone in advanced gastric cancer, with clinically meaningful absolute survival gains and manageable toxicity.
A systematic review examining the state of AI application across the ESD workflow for early gastric cancer, synthesizing progress, limitations, and future directions to inform clinical translation rather than reporting original clinical trial data.
Large, well-powered observational cohort study from a national database demonstrating superior survival with adjuvant versus perioperative chemotherapy in cT2N0 gastric cancer, with multivariable analysis and clear effect sizes, though observational design limits causal inference.