Clinical Implementation of Precision Medicine in Gastric Cancer

Abstract

Gastric cancer (GC) is one of the deadliest malignancies in the world. Currently, clinical treatment decisions are mostly made based on the extent of the tumor and its anatomy, such as tumor-node-metastasis staging. Recent advances in genome-wide molecular technology have enabled delineation of the molecular characteristics of GC. Based on this, efforts have been made to classify GC into molecular subtypes with distinct prognosis and therapeutic response. Simplified algorithms based on protein and RNA expressions have been proposed to reproduce the GC classification in the clinical field. Furthermore, a recent study established a single patient classifier (SPC) predicting the prognosis and chemotherapy response of resectable GC patients based on a 4-gene real-time polymerase chain reaction assay. GC patient stratification according to SPC will enable personalized therapeutic strategies in adjuvant settings. At the same time, patient-derived xenografts and patientderived organoids are now emerging as novel preclinical models for the treatment of GC. These models recapitulate the complex features of the primary tumor, which is expected to facilitate both drug development and clinical therapeutic decision making. An integrated approach applying molecular patient stratification and patient-derived models in the clinical realm is considered a turning point in precision medicine in GC.

Differences in Somatic Mutation Profiles between Korean Gastric Cancer and Gastric Adenoma Patients

“…The life expectancy of GC depends on the stage at the time of diagnosis. The 5-year survival rate of early GC is excellent at more than 90%; on the other hand, that of advanced GC with metastatic disease is less than 30% [ 20 ]. First-line standard treatment includes platinum compounds and fluoropyrimidines with trastuzumab for patients with HER2 -positive GC [ 21 ].…”

Identification and Validation of an Individualized EMT-Related Prognostic Risk Score Formula in Gastric Adenocarcinoma Patients

“…Gastric adenocarcinoma (GAC) is a major fatal type of cancer all around the world with a lack of reliable diagnostic and prognostic biomarker and therapeutic target [10]. It is of great importance for researchers to explore the new diagnostic and therapeutic strategy of GAC on these aspects.…”

Exploring an RNA binding proteins-associated prognostic model for Gastric Cancer

“…Currently, even though some progress have been achieved in diagnosis and therapeutic measures in gastric cancer, the survival rate of GC patients has not been improved remarkably, especially for advanced stage patients. Hence, it is pivotal to identify critical genes related to the molecular mechanisms of GC tumorigenesis and improve the prognosis of GC patients by investigating latent diagnostic and therapeutic targets [31]. To date, the dysregulation of RBPs has been in the limelight in numerous cancer researches.…”