New Strategies for the Treatment of Gastric Cancer: Autophagy, Pyroptosis, Ferroptosis and Tumor Immunity

GUO Chongyuan^1#, SONG Bing^1,2#, LI Hongen³, WANG Yongfeng^1,3, ZHANG Qiqi¹, HE Jin^4
*

(¹Gansu University of Chinese Medicine Research and Experiment Center, Lanzhou 730000, China; ²Gansu Provincial Laboratory Animal Industry Technology Center, Lanzhou 730000, China;³Clinical Medical College of Gansu Medical University, Pingliang 744000, China;⁴Department of Critical Care Medicine, Gansu Provincial People’s Hospital, Lanzhou 730000, China)

Abstract:

Gastric cancer, as one of the most common fatal cancers worldwide, has a low rate of early diagnosis and a poor prognosis in the advanced stage. Although chemotherapy can improve the quality of life of patients with gastric cancer to some extent, it still cannot completely cure the disease. Recent studies have found that the TME (tumor microenvironment) is crucial for the development of gastric cancer. Autophagy, pyroptosis, ferroptosis and tumor immunity in the TME interact with each other and participate in immunotherapy. Their inducers can enhance anti-tumor activity in a way that synergizes with ICIs (immune checkpoint inhibitors). Therefore, the combination of RCD (regulated cell death) inducers and ICIs are expected to become new targets for the treatment of gastric cancer. This article first reviews the autophagy, pyroptosis and ferroptosis pathways. Then, it elaborates in detail on the roles of autophagy, pyroptosis and ferroptosis in the progression of gastric cancer. Finally, it lists the synergistic effects of autophagy, pyroptosis and ferroptosis inducers with ICIs, aiming to achieve the goal of gastric cancer immunotherapy.

CSTR: 32200.14.cjcb.2026.02.0023