Biomaterial-driven remove-remodel-repair (3R) strategy for full-cycle gastric cancer management: bibliometric mapping, preclinical evidence, and a translational roadmap

Gastric cancer (GC) remains a leading cause of cancer mortality worldwide and is characterized by prolonged precancerous progression, dynamic tumor-immune-microbiota interactions, and treatment-associated toxicity that can compromise host defense and tissue recovery. These features create a clinical need for full-cycle management spanning prevention, early eradication, advanced therapy, and postoperative rehabilitation. Here, we propose a biomaterial-driven 3R framework for GC management across the disease continuum, comprising remove for lesion clearance, remodel for immune microenvironment regulation, and repair for tissue restoration. A bibliometric analysis of 1559 publications maps the evolution of biomaterial-enabled GC research and provides an evidence landscape for this framework. Representative nanomaterials, biomimetic hydrogels, engineered microbial carriers, and regenerative matrices are mapped to clinical needs across prevention, endoscopic and perioperative intervention, systemic therapy, and rehabilitation. The 3R occupy distinct translational tiers: remove- and remodel-oriented platforms are predominantly supported by mechanistic preclinical studies, whereas selected repair-oriented materials, including endoscopic hemostatic, sealing, and submucosal-support platforms, already have human clinical evidence. Overall, the 3R framework links therapeutic objectives, material functions, disease stages, and clinically relevant endpoints into a translational roadmap for integrated GC management.