Appearance
Current treatment and recent progress in gastric cancer.
Literature Information
| DOI | 10.3322/caac.21657 |
|---|---|
| PMID | 33592120 |
| Journal | CA: a cancer journal for clinicians |
| Impact Factor | 232.4 |
| JCR Quartile | Q1 |
| Publication Year | 2021 |
| Times Cited | 911 |
| Keywords | adenocarcinoma, gastric cancer, immunotherapy, molecular subtypes, stomach neoplasms |
| Literature Type | Journal Article, Research Support, Non-U.S. Gov't, Review |
| ISSN | 0007-9235 |
| Pages | 264-279 |
| Issue | 71(3) |
| Authors | Smita S Joshi, Brian D Badgwell |
TL;DR
Gastric cancer, while not prevalent in the U.S., is a leading cause of cancer mortality globally, with significant differences in tumor biology between Eastern and Western populations complicating treatment standardization. The study highlights the importance of multidisciplinary approaches and molecular classification, emphasizing the role of biomarkers like MSI and HER2 in guiding personalized therapies and identifying patients who might benefit from immunotherapy, while also noting the need for further research on less differentiated histologic subtypes.
Search for more papers on MaltSci.com
adenocarcinoma · gastric cancer · immunotherapy · molecular subtypes · stomach neoplasms
Abstract
Gastric cancer is not a top-10 malignancy in the United States but represents one of the most common causes of cancer death worldwide. Biological differences between tumors from Eastern and Western countries add to the complexity of identifying standard-of-care therapy based on international trials. Systemic chemotherapy, radiotherapy, surgery, immunotherapy, and targeted therapy all have proven efficacy in gastric adenocarcinoma; therefore, multidisciplinary treatment is paramount to treatment selection. Triplet chemotherapy for resectable gastric cancer is now accepted and could represent a plateau of standard cytotoxic chemotherapy for localized disease. Classification of gastric cancer based on molecular subtypes is providing an opportunity for personalized therapy. Biomarkers, in particular microsatellite instability (MSI), programmed cell death ligand 1 (PD-L1), human epidermal growth factor receptor 2 (HER2), tumor mutation burden, and Epstein-Barr virus, are increasingly driving systemic therapy approaches and allowing for the identification of populations most likely to benefit from immunotherapy and targeted therapy. Significant research opportunities remain for the less differentiated histologic subtypes of gastric adenocarcinoma and those without markers of immunotherapy activity.
MaltSci.com AI Research Service
Intelligent ReadingAnswer any question about the paper and explain complex charts and formulas
Locate StatementsFind traces of a specific claim within the paper
Add to KBasePerform data extraction, report drafting, and advanced knowledge mining
Primary Questions Addressed
- How do the biological differences between Eastern and Western gastric cancer tumors influence treatment decisions?
- What role do molecular subtypes play in the development of personalized therapies for gastric cancer?
- In what ways can the identification of biomarkers like MSI and PD-L1 improve treatment outcomes for gastric cancer patients?
- What are the current challenges in treating less differentiated histologic subtypes of gastric adenocarcinoma?
- How does the acceptance of triplet chemotherapy for resectable gastric cancer impact the future of systemic treatment protocols?
Key Findings
Research Background and Objectives
Gastric cancer, while not among the top ten malignancies in the United States, is a leading cause of cancer-related deaths globally. The biological differences in tumors from Eastern and Western countries complicate the establishment of standard treatment protocols. This study aims to review the current treatment modalities for gastric adenocarcinoma and explore the potential for personalized therapy through molecular classification and biomarkers.
Main Methods/Materials/Experimental Design
The study employs a comprehensive review of existing literature and clinical practices concerning gastric cancer treatment. The focus is on various therapeutic approaches, including systemic chemotherapy, radiotherapy, surgery, immunotherapy, and targeted therapy.
Methodological Flowchart
Key Results and Findings
- Multidisciplinary Treatment: The review emphasizes the necessity of a multidisciplinary approach in treating gastric adenocarcinoma, integrating various therapeutic strategies.
- Triplet Chemotherapy: The acceptance of triplet chemotherapy for resectable gastric cancer is highlighted as a significant advancement in treatment.
- Molecular Classification: The classification of gastric cancer into molecular subtypes is emerging as a crucial factor for tailoring personalized therapies.
- Biomarkers: Specific biomarkers, including MSI, PD-L1, HER2, tumor mutation burden, and Epstein-Barr virus, are becoming instrumental in guiding systemic therapy decisions and identifying patients who may benefit from immunotherapy and targeted therapies.
Main Conclusions/Significance/Innovation
The study underscores the evolving landscape of gastric cancer treatment, advocating for personalized medicine based on molecular profiling. The identification of biomarkers not only aids in the selection of appropriate therapies but also enhances the potential for improved patient outcomes. The integration of triplet chemotherapy marks a pivotal point in managing localized gastric cancer, and the continued exploration of less differentiated histologic subtypes presents further opportunities for innovation in treatment strategies.
Research Limitations and Future Directions
- Limitations: The review acknowledges that there are significant gaps in understanding the less differentiated histologic subtypes of gastric adenocarcinoma and those lacking immunotherapy markers.
- Future Directions: Future research should focus on:
- Investigating the therapeutic responses of less differentiated subtypes.
- Expanding the understanding of biomarkers to enhance the efficacy of immunotherapy.
- Conducting clinical trials to validate personalized treatment approaches based on molecular classification.
This structured summary highlights the complexity of gastric cancer treatment and the importance of a tailored approach, setting the stage for future research and clinical advancements.
References
- Race Is a Risk for Lymph Node Metastasis in Patients With Gastric Cancer. - Naruhiko Ikoma;Mariela Blum;Yi-Ju Chiang;Jeannelyn S Estrella;Sinchita Roy-Chowdhuri;Keith Fournier;Paul Mansfield;Jaffer Ajani;Brian D Badgwell - Annals of surgical oncology (2017)
- Circulating Tumor DNA Sequencing Analysis of Gastroesophageal Adenocarcinoma. - Steven B Maron;Leah M Chase;Samantha Lomnicki;Sara Kochanny;Kelly L Moore;Smita S Joshi;Stacie Landron;Julie Johnson;Lesli A Kiedrowski;Rebecca J Nagy;Richard B Lanman;Seung Tae Kim;Jeeyun Lee;Daniel V T Catenacci - Clinical cancer research : an official journal of the American Association for Cancer Research (2019)
- Preoperative accuracy of gastric cancer staging in patient selection for preoperative therapy: race may affect accuracy of endoscopic ultrasonography. - Naruhiko Ikoma;Jeffrey H Lee;Manoop S Bhutani;William A Ross;Brian Weston;Yi-Ju Chiang;Mariela A Blum;Tara Sagebiel;Catherine E Devine;Aurelio Matamoros;Keith Fournier;Paul Mansfield;Jaffer A Ajani;Brian D Badgwell - Journal of gastrointestinal oncology (2017)
- Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma. - J A Ajani;P F Mansfield;N Janjan;J Morris;P W Pisters;P M Lynch;B Feig;R Myerson;R Nivers;D S Cohen;L L Gunderson - Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2004)
- It Is Time to Stop Using Epirubicin to Treat Any Patient With Gastroesophageal Adenocarcinoma. - Elena Elimova;Yelena Y Janjigian;Mary Mulcahy;Daniel V Catenacci;Mariela A Blum;Khaldoun Almhanna;J Randolph Hecht;Jaffer A Ajani - Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2017)
- GASTRICHIP: D2 resection and hyperthermic intraperitoneal chemotherapy in locally advanced gastric carcinoma: a randomized and multicenter phase III study. - Olivier Glehen;Guillaume Passot;Laurent Villeneuve;Delphine Vaudoyer;Sylvie Bin-Dorel;Gilles Boschetti;Eric Piaton;Alfredo Garofalo - BMC cancer (2014)
- Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. - Yung-Jue Bang;Eric Van Cutsem;Andrea Feyereislova;Hyun C Chung;Lin Shen;Akira Sawaki;Florian Lordick;Atsushi Ohtsu;Yasushi Omuro;Taroh Satoh;Giuseppe Aprile;Evgeny Kulikov;Julie Hill;Michaela Lehle;Josef Rüschoff;Yoon-Koo Kang; - Lancet (London, England) (2010)
- Lapatinib in Combination With Capecitabine Plus Oxaliplatin in Human Epidermal Growth Factor Receptor 2-Positive Advanced or Metastatic Gastric, Esophageal, or Gastroesophageal Adenocarcinoma: TRIO-013/LOGiC--A Randomized Phase III Trial. - J Randolph Hecht;Yung-Jue Bang;Shukui K Qin;Hyun C Chung;Jianming M Xu;Joon O Park;Krzysztof Jeziorski;Yaroslav Shparyk;Paulo M Hoff;Alberto Sobrero;Pamela Salman;Jin Li;Svetlana A Protsenko;Zev A Wainberg;Marc Buyse;Karen Afenjar;Vincent Houé;Agathe Garcia;Tomomi Kaneko;Yingjie Huang;Saba Khan-Wasti;Sergio Santillana;Michael F Press;Dennis Slamon - Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2016)
- Low metabolic activity in primary gastric adenocarcinoma is associated with resistance to chemoradiation and the presence of signet ring cells. - Kazuto Harada;Madhavi Patnana;Xuemei Wang;Masaaki Iwatsuki;Mariela A Blum Murphy;Meina Zhao;Prajnan Das;Bruce D Minsky;Brian Weston;Jeffrey H Lee;Manoop S Bhutani;Jeannelyn S Estrella;Namita Shanbhag;Naruhiko Ikoma;Brian D Badgwell;Jaffer A Ajani - Surgery today (2020)
- Microsatellite Instability and Programmed Cell Death-Ligand 1 Expression in Stage II/III Gastric Cancer: Post Hoc Analysis of the CLASSIC Randomized Controlled study. - Yoon Young Choi;Hyunki Kim;Su-Jin Shin;Ha Yan Kim;Jinae Lee;Han-Kwang Yang;Woo Ho Kim;Young-Woo Kim;Myeong-Cherl Kook;Young Kyu Park;Hyung-Ho Kim;Hye Seung Lee;Kyung Hee Lee;Mi Jin Gu;Seung Ho Choi;SoonWon Hong;Jong Won Kim;Woo Jin Hyung;Sung Hoon Noh;Jae-Ho Cheong - Annals of surgery (2019)
Literatures Citing This Work
- Everything, in Retrospect, is Obvious. - Brian Badgwell - Annals of surgical oncology (2021)
- The emerging role of miR-10 family in gastric cancer. - Fang Liu;Yanfen Shi;Zuolong Liu;Ziyi Li;Wei Xu - Cell cycle (Georgetown, Tex.) (2021)
- The RNA-Binding Protein NELFE Promotes Gastric Cancer Growth and Metastasis Through E2F2. - Changyu Chen;Qiang Zheng;Shubo Pan;Wenzheng Chen;Jianfeng Huang;Yi Cao;Yi Tu;Zhengrong Li;Changjun Yu;Zhigang Jie - Frontiers in oncology (2021)
- Prognostic Role of Receptor Tyrosine Kinase-Like Orphan Receptors in Intestinal-Type Gastric Cancer. - Rajeev Nema;Priti Patel;Ashok Kumar - Asian Pacific journal of cancer prevention : APJCP (2021)
- Comprehensive Analysis of the Value of SMYD Family Members in the Prognosis and Immune Infiltration of Malignant Digestive System Tumors. - Donghui Liu;Xuyao Wang;Enhong Shi;Liru Wang;Minghao Nie;Long Li;Qingxin Jiang;Pengyu Kong;Shuai Shi;Chao Wang;Sen Yan;Zhihui Qin;Shuang Zhao - Frontiers in genetics (2021)
- Effect of LAMA4 on Prognosis and Its Correlation with Immune Infiltration in Gastric Cancer. - Mingming Wang;Changzheng Li;Ying Liu;Zuomin Wang - BioMed research international (2021)
- Safety and Efficacy of Laparoscopic Versus Open Gastrectomy in Patients With Advanced Gastric Cancer Following Neoadjuvant Chemotherapy: A Meta-Analysis. - Xu-Liang Liao;Xian-Wen Liang;Hua-Yang Pang;Kun Yang;Xin-Zu Chen;Xiao-Long Chen;Kai Liu;Lin-Yong Zhao;Wei-Han Zhang;Jian-Kun Hu - Frontiers in oncology (2021)
- LncRNA PITPNA-AS1 promotes gastric cancer by increasing SOX4 expression via inhibition of miR-92a-3p. - Licheng Liu;Anna Dai;Zao Zhang;Meiying Ning;Dong Han;Li Li;Zhuangzhuang Li - Aging (2021)
- Efficiency of complete omentectomy in patients with resectable gastric cancer: a meta‑analysis and systematic review. - Akao Zhu;Guang Yin;Xinchun Liu;Wencheng Kong;Yu Zhang;Yuqiang Shan;Rongchao Ying;Jian Zhang;Chunhua Zhou - BMC gastroenterology (2021)
- Tumor-Infiltrating Neutrophils and Non-Classical Monocytes May Be Potential Therapeutic Targets for HER2negative Gastric Cancer. - Juhee Jeong;Duk Ki Kim;Ji-Hyeon Park;Do Joong Park;Hyuk-Joon Lee;Han-Kwang Yang;Seong-Ho Kong;Keehoon Jung - Immune network (2021)
... (901 more literatures)
© 2025 MaltSci - We reshape scientific research with AI technology