Gastric Cancer in the Era of Precision Medicine

Abstract

Gastric cancer (GC) remains the third most common cause of cancer death worldwide, with limited therapeutic strategies available. With the advent of next-generation sequencing and new preclinical model technologies, our understanding of its pathogenesis and molecular alterations continues to be revolutionized. Recently, the genomic landscape of GC has been delineated. Molecular characterization and novel therapeutic targets of each molecular subtype have been identified. At the same time, patient-derived tumor xenografts and organoids now comprise effective tools for genetic evolution studies, biomarker identification, drug screening, and preclinical evaluation of personalized medicine strategies for GC patients. These advances are making it feasible to integrate clinical, genome-based and phenotype-based diagnostic and therapeutic methods and apply them to individual GC patients in the era of precision medicine.

Patient-derived organoid models help define personalized management of gastrointestinal cancer

“…Although mortality has declined for colonic cancer, death rates have increased for gastric, pancreatic and liver cancer. With incidence rates that are rising steadily, and therapies that remain largely ineffective, it is estimated that in 2020 pancreatic and liver cancer will become the second and third most lethal cancers worldwide.…”

Podocalyxin‐like protein promotes gastric cancer progression through interacting with RUN and FYVE domain containing 1 protein

“…Numerous molecules contribute to GC through partially characterized or unknown mechanisms . Therefore, it is crucial to search for highly specific markers for predicting prognosis and response to therapy …”

“…3 Therefore, it is crucial to search for highly specific markers for predicting prognosis and response to therapy. 3,4 Podocalyxin-like protein is a cell surface transmembrane glycoprotein that belongs to the CD34 family. 5 PODXL was first defined as a heavily sialylated and sulfated membrane protein, which expressed on the apical surface of glomerular epithelial cells or podocytes in the kidney.…”

Ratio‐based staging systems are better than the 7th and 8th editions of the TNM in stratifying the prognosis of gastric cancer patients: A multicenter retrospective study

“…Indeed, it is of great importance to identify an optimal staging system to define the best treatment strategy and the best surveillance scheme for every stage of the disease. Currently, many novel extra‐TNM factors are available to further characterize the disease of every patient with GC . However, as these novel factors have not yet been included in the current staging systems, it is still fundamental to ensure the availability of a system which is the most accurate and reliable as possible.…”

“…Currently, many novel extra-TNM factors are available to further characterize the disease of every patient with GC. [26][27][28] However, as these novel factors have not yet been included in the current staging systems, it is still fundamental to ensure the availability of a system which is the most accurate and reliable as possible. This system should be solid in every subgroup of patients, even in those where a poor primary lymph node count or a suboptimal surgical treatment or inaccurate pathological retrieval of lymph nodes could compromise a correct staging.…”