Molecular profiling in gastroesophageal cancer—clinical routine and future perspective

Abstract

Although several large clinical trials have been conducted in order to investigate targeted inhibition of several molecular pathways in gastric cancer, only a limited number of targeted therapies have been introduced in clinical routine. Besides scientific interest, international guidelines recommend investigation of some distinct molecular alterations, which are associated with therapeutic consequences. These are (i) human epidermal growth factor receptor 2 (HER2), (ii) programmed death receptor 1 (PD-L1) and (iii) microsatellite instability (MSI). There are some emerging markers, such as Epstein-Barr virus (EBV), which might also be associated with a favorable response to immunotherapy. These routine and potential markers will be further discussed in the scope of this short review.

Mismatch Repair System Genomic Scars in Gastroesophageal Cancers: Biology and Clinical Testing

“…Comprehensive molecular analyses allowed for the classification of GEC into four groups characterized by either (i) Epstein-Barr virus (EBV) infection (9%), (ii) high MSI (MSI-H) (22%), (iii) genomic stability (20%), or (iv) chromosomal instability (50%) [13]. Among these molecular subtypes, dMMR/MSI-H GECs are associated with older age (median 72 years), female gender (56%), distal third of the stomach localization, intestinal-type histology, and lower stage [14]. Unlike EBV POS GEC, MSI-H tumors usually lack actionable amplifications, such as those involving Janus kinase 2 (JAK2) and HER2 [15,16].…”

Molecular profiling—ready for clinical routine

“…In this special issue of the Magazine of European Medical Oncology (MEMO) multidisciplinary experts summarize and discuss recent developments and future perspectives of comprehensive molecular profiling spanning from specific cancer entities to agnostic approaches [1][2][3].…”