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

World Journal of Gastrointestinal Oncology 2017年第5期9卷 194-208页

作者： 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 Department of Oncology University and General Hospital Medical Oncology University Hospital Medical Oncology National Cancer InstituteIRCCS Department of Oncology University Hospital

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, specifictargeted 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.

关键词： Molecular biology Immunotherapy Gastric cancer Classification Targeted therapy

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