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From Early Escape to Immune Evasion: Mapping Drug Resistance in Advanced Gastric Cancer

A next-generation antibody-drug conjugate has transformed treatment for HER2-positive gastric cancer, yet many patients fail to benefit or relapse rapidly. Using single-cell analysis of patient tumor samples, researchers uncovered distinct mechanisms that drive both early and late resistance to trastuzumab deruxtecan. The study shows that tumors resistant from the outset are marked by a mucus-associated protein that limits drug binding, while cancers that relapse later suppress drug activation and reshape their immune environment. By linking cellular heterogeneity, metabolic reprogramming, and immune escape, the findings reveal why a highly potent therapy can lose effectiveness--and point to biomarkers and combination strategies that could help restore durable responses.

February 16, 2026


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