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This research article investigates biomarkers and cellular ecosystems that influence how gastric cancer patients respond to perioperative immunotherapy and chemotherapy. By analyzing data from the NEOSUMMIT-01 clinical trial, the authors identified specific genetic factors, such as HLA-B and LRP1B mutations, that serve as predictors for treatment success. The study categorizes the tumor microenvironment into five distinct ecotypes, ranging from immune-active zones that favor recovery to immunosuppressive regions that resist therapy. A critical discovery involves APOA1+ tumor cells, which appear to drive resistance by signaling TREM2+ macrophages to adopt a suppressive state. These findings suggest that targeting these metabolic and immune interactions could improve the effectiveness of treatments for locally advanced gastric cancer. References: • Zhao Q, Huang R, Wang C, et al. Dissecting genetic and immune drivers of heterogeneous responses to neoadjuvant immunochemotherapy in gastric cancer[J]. Cancer Cell, 2026.