{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:02:26Z","timestamp":1789470146529,"version":"build-2803163510"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Chemotherapy, immune checkpoint blockade, HER2-targeted therapy, and anti-angiogenic therapy have widened treatment options for gastric cancer, yet residual disease and acquired resistance remain common. Cancer-associated fibroblasts (CAFs) are often classified as fixed subtypes, even though treatment exposes them to tissue injury, inflammatory cytokines, hypoxia, altered interstitial pressure, and matrix stress. We use treatment-shaped fibroblast state to describe a functional program that arises through reprogramming within resident fibroblasts, recruitment from a local mesenchymal source, or enrichment of a pre-existing state that survives therapy. An unpaired change in abundance cannot distinguish these mechanisms. The review follows four time points: the baseline ecosystem, acute therapeutic stress, the residual disease niche, and the acquired resistance circuit. Interferon-responsive and senescence-associated programs may be short-lived and either recruit or suppress immune cells. By contrast, persistent matrix, vascular, metabolic, and paracrine programs can protect residual tumor cells during treatment. Gastric cancer studies implicate TGF-\u03b2-SMAD, IL-6-JAK-STAT3, GAS6-AXL, CXCL12-CXCR4, NRP2, LOX, FAK, and extracellular matrix pathways. Longitudinal human evidence is limited and is sensitive to biopsy timing, spatial sampling, and single-cell dissociation bias. Translational studies should pair spatial specimens with collagen-turnover and extracellular-vesicle biomarkers, mechanically matched organoid-CAF co-cultures, and immunocompetent or humanized models. Treatment should disrupt or reprogram the state that sustains residual disease without removing fibroblast functions that support immunity or restrain tissue injury.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1958611","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:04:08Z","timestamp":1789466648000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapy-educated fibroblast states link treatment pressure to residual disease and acquired resistance in gastric cancer"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhigang","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, The 940th Hospital of Joint Service Logistics Support Force of Chinese People's Liberation Army","place":["Lanzhou, 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