China, Japan, and other Asian countries have some of the highest rates of gastric cancer worldwide. In China, the majority of patients are still diagnosed at an advanced stage, having already lost the opportunity for curative surgery. Effective systemic therapy is therefore essential for improving survival. In recent years, innovative drugs represented by antibody–drug conjugates (ADCs)—such as the HER2-targeted ADC trastuzumab deruxtecan (T-DXd)—have achieved major breakthroughs in pivotal clinical studies including DESTINY-Gastric04. These advances are expected to gradually transform the treatment landscape starting from later lines of therapy. Asian clinical researchers have played an important role in these studies, contributing insights that are redefining clinical practice.
