From Tumor Biology to Clinical Perspectives: Novel Biomarkers and Therapeutic Insights in Gastric Cancer.

Gastric cancer (GC) is a leading cause of cancer-related mortality worldwide. Accurate early detection, timely diagnostic stratification, and robust prognostic risk assessment are essential for optimizing clinical outcomes and improving survival duration. However, conventional serological biomarkers demonstrate limited diagnostic performance owing to suboptimal sensitivity and specificity, while standard chemotherapy and targeted therapies provide only modest survival benefits in GC. Marked inter- and intratumoral heterogeneity further characterizes GC as a biologically complex and treatment-resistant malignancy. To date, significant progress has been made in comprehensively delineating the complex molecular pathogenesis of GC, providing a strong rationale for the development of novel biomarkers and promising therapeutic targets. The aim of this review is to systematically summarize recent advances ranging from aberrant genetic and epigenetic alterations; dysregulation of oncogenic signaling pathways; sophisticated crosstalk within the tumor microenvironment; intricate microbiota-inflammation interactions; fundamental discoveries to potential clinical translation, including novel biomarkers for early detection, diagnosis and prognostic stratification; and emerging therapeutic strategies for GC. Collectively, this work provides a conceptual framework for advancing precision medicine in GC.