Novel Biomarkers of Gastric Cancer: Current Research and Future Perspectives

Gastric cancer is a heterogeneous disease with diverse histological and genomic subtypes, making it difficult to demonstrate treatment efficacy in clinical trials. However, recent efforts have been made to identify molecular biomarkers with prognostic and predictive implications to better understand the broad heterogeneity of gastric cancer and develop effective targeted therapies for it. HER2 overexpression, HER2/neu amplification, MSI-H, and PD-L1+ are predictive biomarkers in gastric cancer, and a growing number of clinical trials based on novel biomarkers have demonstrated the efficacy of targeted therapies alone or in combination with conventional chemotherapy. Enrichment design clinical trials of targeted therapies against FGFR2b and claudin 18.2 have demonstrated efficacy in unresectable advanced gastric cancer. Nonetheless, it is essential to continuously validate promising molecular biomarkers and introduce them into clinical practice to optimize treatment selection and improve patient outcomes. In this review, we focused on established (PD-L1, HER2, MSI) and emerging biomarkers (FGFR2, CLDN18.2) in gastric cancer, their clinical significance, detection methods, limitations, and molecular agents that target these biomarkers.

Automated summary

Gastric cancer's heterogeneity makes it difficult to demonstrate treatment efficacy, but efforts have been made to identify molecular biomarkers to better understand this heterogeneity and develop targeted therapies. HER2 overexpression, HER2/neu amplification, MSI-H, and PD-L1+ are predictive biomarkers in gastric cancer, and clinical trials have shown the efficacy of targeted therapies. Enrichment design clinical trials have also demonstrated efficacy in unresectable advanced gastric cancer. Continuous validation and introduction of promising biomarkers into clinical practice are essential for optimal treatment selection and improved patient outcomes.