Predictive biomarkers in gastric cancer

Area of Science:

• Oncology
• Molecular Diagnostics
• Gastroenterology

Background:

• Gastric cancer is a leading cause of cancer-related deaths globally, often diagnosed at advanced stages.
• Current treatment strategies vary between Western and Eastern countries, including neoadjuvant/perioperative and adjuvant chemotherapy.
• Precision medicine relies on predictive biomarkers for effective patient stratification and treatment selection.

Purpose of the Study:

• To review advancements in tissue-based diagnostic biomarkers for gastric cancer.
• To discuss the morpho-molecular classification of gastric cancer and its implications.
• To highlight the role of biomarkers in identifying therapeutic targets and guiding treatment decisions.

Main Methods:

• Review of current literature on gastric cancer biomarkers.
• Analysis of morpho-molecular classification of gastric cancer subtypes.
• Discussion of diagnostic techniques including next-generation sequencing.

Main Results:

• Gastric cancer classification includes Epstein-Barr-Virus (EBV)-positive, microsatellite instable, genomically stable, and chromosomal instable subtypes.
• Chromosomal instable tumors frequently overexpress receptor tyrosine kinases (e.g., EGFR, FGFR2, HER2, MET).
• EBV-positive and microsatellite instable subtypes often express immune checkpoint molecules (PD-L1, VISTA); genomically stable tumors show claudin 18.2 alterations.

Conclusions:

• Tissue-based biomarkers are vital for precision medicine in gastric cancer.
• Accurate tissue sampling is critical due to intratumoral heterogeneity.
• Emerging biomarkers and molecular classifications offer new avenues for targeted therapies in advanced gastric cancer.