Journal
THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY
Volume 8, Issue 2, Pages 113-125Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1758834015616935
Keywords
chromosomal instability; clinical trials; Epstein Barr virus; gastric cancer; gastroesophageal cancer; genomically stable; microsatellite instability; molecular profiling; The Cancer Genome Atlas
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Funding
- NIHR ICR/RMH BRC
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Gastric cancer is responsible for a high burden of disease globally. Although more extensive use of chemotherapy together with the recent introduction of the two targeted agents trastuzumab and ramucirumab have contributed to marginal outcome prolongation, overall survival for patients with advanced stage disease remains poor. Over the last decade, a number of novel agents have been examined in clinical trials with largely disappointing results. Potential explanations for this are the absence of molecularly selected trial populations or weak predictive biomarkers within the context of a highly heterogeneous disease. In the recently published gastric cancer The Cancer Genome Atlas (TCGA) project a new classification of four different tumour subtypes according to different molecular characteristics has been proposed. With some overlap, several relatively distinct and potentially targetable pathways have been identified for each subtype. In this perspective review we match recent trial results with the subtypes described in the gastric cancer TCGA aiming to highlight data regarding novel agents under evaluation and to discuss whether this publication might provide a framework for future drug development.
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