胃腺癌（GAC）仍然是世界范围内普遍存在的癌症，其发病率在南美洲呈上升趋势。 GAC 的异质性使得管理方面的进展充满挑战。尽管存在挑战，但最近的治疗目标是个体化治疗。对于微卫星不稳定性高/错配修复缺陷的局部疾病，免疫疗法现已成为一种采用的做法。在晚期不可切除的情况下，那些含有人表皮生长因子受体 2 (HER2) 表达的细胞仍然是一个单独的实体。未来的目标正在开发中。其中包括密蛋白 18.2 (CLDN18.2)、成纤维细胞生长因子受体 2b (FGFR2b) 和滋养层细胞表面抗原 2 (TROP-2)。 FDA 预计很快就会批准 zolbetuximab（一种抗 CLDN 18.2 单克隆抗体）。此外，抗 FGFR2b 单克隆抗体 bemarituzumab 与化疗联合治疗 HER2 阴性 GAC 且 FGFR2 过表达的患者显示出改善。该组合目前正在第三阶段试验中进行研究。最后，TROP-2 已成为令人兴奋的实体瘤靶标，预计将在 GAC 中进行研究。近年来，所有这三个治疗靶点都出现了大量的药物开发，我们预计未来几年会有更新的靶向药物推动 GAC 的治疗决策。

Gastric adenocarcinoma (GAC) remains a prevalent cancer worldwide and its incidence is increasing in South America. The heterogenous nature of GAC makes advances in management challenging.Despite challenges, recent therapeutic targets are individualizing treatment. For localized disease with microsatellite-instability-high/deficient mismatch repair, immunotherapy is now an adopted practice. In the advanced unresectable setting, those harboring human epidermal growth factor receptor-2 (HER2) expression continue to be a separate entity.Future targets are developing. Among these include claudin 18.2 (CLDN18.2), fibroblast growth factor receptor 2b (FGFR2b), and trophoblast cell surface antigen-2 (TROP-2). FDA approval of zolbetuximab's, an anti-CLDN 18.2 monoclonal antibody, is expected soon. Additionally, bemarituzumab, ananti-FGFR2b monoclonal antibody, has shown improvements in combination with chemotherapy in those with HER2 negative GAC with FGFR2 overexpression. This combination is now being investigated in a phase 3 trial. Lastly, TROP-2 has emerged as an exciting solid tumor target and study is expected in GAC. All three of these therapeutic targets have seen an abundance of drug development in recent years, and we anticipate newer targeted agents driving therapeutic decisions in GAC in the coming years.