Simple SummaryStomach cancers remain highly aggressive cancers with poor patient outcomes; however, in the last two decades there has been a lot of clinical research into understanding targets and potential for targeted treatments in advanced stomach cancers, with some treatments that have already reached patients and have been shown to improve outcomes. In this article, we will summarise the recent advancements in targeted therapies and precision medicine in gastric cancer and discuss new treatments potentially on the horizon.AbstractGastric cancer is an aggressive disease with survival remaining poor in the advanced setting. More than a decade after the first targeted treatment was approved, still only HER2, MSI and PDL-1 status have reached everyday practice in terms of guiding treatment options for these patients. However, various new targets and novel treatments have recently been investigated and have shown promise in improving survival outcomes. In this review, we will summarise previous and currently ongoing studies on predictive biomarkers, possible new targeted treatments, potential reasons for conflicting trial results and hope for the future of precision medicine in gastric cancer.