Clinical Implications of Molecular Heterogeneity of Gastric Cancer

Abstract

Gastric cancer incidence has been steadily declining in countries with low frequencies of gastric carcinoma since early 1930s. In areas with higher incidences, the decline has been less obvious and slower. Nevertheless, gastric adenocarcinoma remains one of the most common causes of cancer-related death worldwide. The poor outcome has been attributed to late detection of the condition, particularly in Americas and Europe, aggressive pathogenesis and lack of symptoms during early stages of the tumor development. In addition, sporadic stomach cancer mostly affects elderly individuals. In the majority of countries with low incidence, the average age at the disease presentation is above 65. Therefore, gastric adenocarcinoma, among other diseases associated with old age, raises health concerns in countries with changing demographic age profiles that show a trend of an increase in the proportion of the population aged over 60. The low 5-year survival rate of patients underscores the critical need for the development of more accurate diagnostic tools and safe targeted chemotherapeutics. However, the heterogeneity of molecular changes represents one of the most pressing issues in the current research of gastric cancer, impeding the translation of genetic aberrations into novel applications for medical practice.

Recent Trends and Advancements in the Diagnosis and Management of Gastric Cancer

“…The amount of clinical data is growing every day but despite this, there are currently not enough high-quality, well-designed multi-center prospective trials available. Furthermore, the enormous inter-tumor and intra-tumor heterogeneity of GC across individuals and populations results in a lag in transitioning the current molecular research into clinical practice for patient benefit [ 205 ]. The diagnosis and treatment approaches used in the East and West also differ significantly [ 206 ].…”