Molecular classification of gastric cancer

Gastric cancer (GC) remains a public health problem, being the fifth most common cancer worldwide. In the western countries, the majority of patients present with advanced disease. Additionally, 65 to 75% of patients treated with curative intent will relapse and develop systemic disease. In metastatic disease, systemic treatment still represents the state of the art, with less than a year of median overall survival. The new molecular classification of GC was published in 2014, identifying four distinct major subtypes of gastric cancer, and has encouraged the investigation of new and more personalized treatment strategies. This paper will review the current evidence of immunotherapy in advanced gastric cancer.

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New therapeutic options opened by the molecular classification of gastric cancer

World Journal of Gastroenterology ◽

10.3748/wjg.v24.i18.1942 ◽

2018 ◽

Vol 24 (18) ◽

pp. 1942-1961 ◽

Cited By ~ 8

Author(s):

Mihaela Chivu-Economescu ◽

Lilia Matei ◽

Laura G Necula ◽

Denisa L Dragu ◽

Coralia Bleotu ◽

...

Keyword(s):

Gastric Cancer ◽

Molecular Classification ◽

Therapeutic Options

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Molecular Classification of Gastric Cancer: A New Paradigm

Yearbook of Pathology and Laboratory Medicine ◽

10.1016/j.ypat.2011.11.049 ◽

2012 ◽

Vol 2012 ◽

pp. 260-261

Author(s):

S.S. Raab

Keyword(s):

Gastric Cancer ◽

Molecular Classification ◽

New Paradigm

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From Tumor Immunology to Immunotherapy in Gastric and Esophageal Cancer

International Journal of Molecular Sciences ◽

10.3390/ijms20010013 ◽

2018 ◽

Vol 20 (1) ◽

pp. 13 ◽

Cited By ~ 23

Author(s):

David Vrána ◽

Marcel Matzenauer ◽

Čestmír Neoral ◽

René Aujeský ◽

Radek Vrba ◽

...

Keyword(s):

Gastric Cancer ◽

Esophageal Cancer ◽

Checkpoint Inhibitors ◽

Cell Cancer ◽

Predictive Biomarkers ◽

Molecular Classification ◽

Novel Treatment ◽

Predictive Role ◽

Repair Genes

Esophageal and gastric cancers represent tumors with poor prognosis. Unfortunately, radiotherapy, chemotherapy, and targeted therapy have made only limited progress in recent years in improving the generally disappointing outcome. Immunotherapy with checkpoint inhibitors is a novel treatment approach that quickly entered clinical practice in malignant melanoma and renal cell cancer, but the role in esophageal and gastric cancer is still poorly defined. The principal prognostic/predictive biomarkers for immunotherapy efficacy currently considered are PD-L1 expression along with defects in mismatch repair genes resulting in microsatellite instability (MSI-H) phenotype. The new molecular classification of gastric cancer also takes these factors into consideration. Available reports regarding PD-1, PD-L1, PD-L2 expression and MSI status in gastric and esophageal cancer are reviewed to summarize the clinical prognostic and predictive role together with potential clinical implications. The most important recently published clinical trials evaluating checkpoint inhibitor efficacy in these tumors are also summarized.

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Gastric Cancer: Recent Molecular Classification Advances, Racial Disparity, and Management Implications

Journal of Oncology Practice ◽

10.1200/jop.17.00025 ◽

2018 ◽

Vol 14 (4) ◽

pp. 217-224 ◽

Cited By ~ 15

Author(s):

Aravind Sanjeevaiah ◽

Naga Cheedella ◽

Caitlin Hester ◽

Matthew R. Porembka

Keyword(s):

Gastric Cancer ◽

Native American ◽

Gastric Adenocarcinoma ◽

Racial Disparity ◽

Tumor Biology ◽

Molecular Classification ◽

Management Implications ◽

Cancer Subtypes ◽

Marginal Improvement

Gastric adenocarcinoma remains an aggressive and poorly understood malignancy with a heterogeneous presentation and tumor biology. The current histologic and anatomic classification has been ineffective in guiding therapy, with only marginal improvement in outcome over time. Furthermore, the variation in presentation and disease among racial and ethnic groups amplifies the complexity of this cancer. An understanding of the clinical and molecular variability is important for effective treatment. Recent advances in molecular biology have better defined gastric cancer subtypes. We systematically review recent literature on the molecular classification of gastric adenocarcinoma and the associated management implications, with an emphasis on Hispanic and Native American populations.

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