Molecular classifications of gastric cancers: Novel insights and possible future applications

Silvio Ken Garattini, Debora Basile, Monica Cattaneo, Valentina Fanotto, Elena Ongaro, Marta Bonotto, Francesca V. Negri, Rosa Berenato, Paola Ermacora, Giovanni Gerardo Cardellino, Mariella Giovannoni, Nicoletta Pella, Mario Scartozzi, Lorenzo Antonuzzo, Nicola Silvestris, Gianpiero Fasola, Giuseppe Aprile

Research output: Contribution to journalArticle

Abstract

Despite some notable advances in the systemic management of gastric cancer (GC), the prognosis of patients with advanced disease remains overall poor and their chance of cure is anecdotic. In a molecularly selected population, a median overall survival of 13.8 mo has been reached with the use of human epidermal growth factor 2 (HER2) inhibitors in combination with chemotherapy, which has soon after become the standard of care for patients with HER2-overexpressing GC. Moreover, oncologists have recognized the clinical utility of conceiving cancers as a collection of different molecularlydriven entities rather than a single disease. Several molecular drivers have been identified as having crucial roles in other tumors and new molecular classifications have been recently proposed for gastric cancer as well. Not only these classifications allow the identification of different tumor subtypes with unique features, but also they serve as springboard for the development of different therapeutic strategies. Hopefully, the application of standard systemic chemotherapy, specific targeted agents, immunotherapy or even surgery in specific cancer subgroups will help maximizing treatment outcomes and will avoid treating patients with minimal chance to respond, therefore diluting the average benefit. In this review, we aim at elucidating the aspects of GC molecular subtypes, and the possible future applications of such molecular analyses.

Original languageEnglish
Pages (from-to)194-208
Number of pages15
JournalWorld Journal of Gastrointestinal Oncology
Volume9
Issue number5
DOIs
Publication statusPublished - May 1 2017

Keywords

  • Classification
  • Gastric cancer
  • Immunotherapy
  • Molecular biology
  • Targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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