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Review
. 2019 Oct 14;25(38):5773-5788.
doi: 10.3748/wjg.v25.i38.5773.

Targeted therapies in metastatic gastric cancer: Current knowledge and future perspectives

Antonio Pellino  1 , Erika Riello  1 , Floriana Nappo  1 , Stefano Brignola  2 , Sabina Murgioni  1 , Selma Ahcene Djaballah  1 , Sara Lonardi  1 , Vittorina Zagonel  1 , Massimo Rugge  2 , Fotios Loupakis  1 , Matteo Fassan  3
Affiliations
Review

Targeted therapies in metastatic gastric cancer: Current knowledge and future perspectives

Antonio Pellino et al. World J Gastroenterol. .

Abstract

Gastric cancer (GC) represents a leading cause of cancer related morbidity and mortality worldwide accounting for more than 1 million of newly diagnosed cases and thousands of deaths every year. In the last decade, the development of targeted therapies and the optimization of already available chemotherapeutic drugs has expanded the available treatment options for advanced GC and granted better survival expectations to the patients. At the same time, global efforts have been undertaken to investigate in detail the genomic and epigenomic heterogeneity of this disease, resulting in the identification of new specific and sensitive predictive and prognostic biomarkers and in innovative molecular classifications based on gene expression profiling. Nonetheless, several randomized studies aimed at exploring new innovative agents, such as immune checkpoint inhibitors, failed to demonstrate clinically meaningful survival advantages. Therefore, it is essential to further improve the molecular characterization of GC subgroups in order to provide researchers and medical oncologists with new tools for patients' selection and stratification in future clinical development programs and subsequent trials. The aim of the present manuscript is to provide a global overview of the recent molecular classifications from The Cancer Genome Atlas and the Asian Cancer Research Group and to present key promising developments in the field of immunotherapy and targeted therapies in metastatic GC.

Keywords: Asian Cancer Research Group; Gastric cancer; Molecular diagnostic; Personalized medicine; Predictive biomarkers; The Cancer Genome Atlas.

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Conflict of interest statement

Conflict-of-interest statement: Fotios Loupakis had roles as consultant or advisor for Roche, Bayer, Amgen and Genentech. Sara Lonardi had roles as consultant or advisor for Amgen, Bayer, Merck Serono, Lilly; she received research funding from Amgen, Merck Serono and she is part of speakers bureau of Lilly, BMS. Vittorina Zagonel received honoraria and had roles as consultant or advisor for Bristol-Mayers Squibb, Bayer, Roche, Pfizer, Janssen, Novartis, Astellas, Servier; he had roles as consultant or advisor for Celgene, Merck. Matteo Fassan received research funding from Astellas Pharma. All the others authors declare no conflict of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
The cancer genome atlas and the Asian cancer research group molecular classification of gastric cancer. EBV: Epstein-Barr; CIN: Chromosomal instability; MSI: Microsatellite instability; GS: Genomically stable tumours; MSS/EMT: Microsatellite unstable type, epithelial to mesenchymal-like type.
See this image and copyright information in PMC

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