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Gastric cancer is one of the malignant tumors with high incidence in China, with a 5-year relative survival rate of about 40%, which is characterized by low early diagnosis rate, large tumor load, high heterogeneity and poor prognosis. In the past 20 years, the multidisciplinary team model and individualized and precise decisions have become recognized measures to effectively improve the comprehensive treatment efficacy of gastric cancer. For the treatment of cancer, it has gradually transitioned from the simple evidence-based model of the “thousand people” to “precision immunotherapy”. The field of gastric cancer has made breakthroughs in many aspects in 2022, covering molecular mechanism exploration, diagnosis technology and treatment strategy, clinical transformation, precision medicine and immunotherapy became research hotspots. The research in targeted drugs mainly focus on a few hot targets (such as CLDN18.2 and FGFR2b). In the field of immunotherapy, domestic programmed death-1 (PD-1) inhibitors are gradually emerging (in the study of RATIONALE 305), and more attention is being paid to the reduction of toxicity (in the Moonlight study) and the exploration of new treatment models (in the targeted combination immunotherapy: LEAP-015 study; in the immunotherapy combined with radiotherapy: Neo-PLANET study). This paper reviewed the progress of gastric cancer research in 2022, and provided ideas and suggestions for more accurate understanding of its pathogenesis, in-depth clinical translational research and formulation of clinical practice programs.