关键词: 胃癌, 免疫治疗, 辅助治疗, 免疫检查点抑制剂, 化疗

Abstract: For postoperative adjuvant therapy in patients with locally advanced gastric cancer, immunotherapy has the potential to improve prognosis, but existing evidence still cannot shake the cornerstone position of chemotherapy. Accurately screening potential beneficiaries of immunotherapy is the key to addressing the poor efficacy of adjuvant immunotherapy in the entire population after surgery. It is recommended to first screen the population with potential immune benefits, such as EBV positive, dMMR/MSI-H，and PD-L1 high expression，based on the molecular classification and biomarkers of the tumor. Then, combined with the patient's immune therapy tolerance, postoperative pathological stage, histological classification, and economic family status, the risk and benefit ratio of immune therapy should be comprehensively evaluated to develop the best treatment plan.

Key words: gastric cancer, immunotherapy, adjuvant therapy, immune checkpoint inhibitors, chemotherapy