Integrated clinico-molecular analysis of gastric cancer in European and Latin American populations: LEGACY project

R Dienstmann¹, E Ruiz-García², M Alsina³, F Ruiz-Pace⁴, T S Groen-van Schooten⁵, C Martínez-Ciarpaglini⁶, E A Fernández-Figueroa⁷, R Herrera-Goepfert⁸, C Díaz-Romero⁹, L Lino-Silva¹⁰, A I Hernandez-Guerrero¹¹, N M Valdez-Reyes¹², A León-Takahashi¹³, J C Falcón-Martínez¹², R E Pouw¹⁴, S Romero¹⁵, R Villagrasa¹⁶, M Cabeza-Segura¹⁷, L Alarcón-Molero¹⁸, E Jimenez-Martí¹⁹, A Miralles²⁰, H Boggino²¹, C Gauna²², R Pereira²², H Lezcano²³, D Cantero²⁴, A Vivancos²⁵, J Matito²⁶, A Martin²⁷, M Gómez²⁸, E Castillo²⁹, M Vila³⁰, R M Ferreira³¹, R Barros³², J Santos-Antunes³³, M Mendes-Rocha³⁴, A Costa³⁵, E Riquelme³⁶, J C Roa³⁷, G Latorre³⁸, B Freile³⁹, L Caro⁴⁰, F Esteso⁴¹, J O'Connor⁴², A Riquelme⁴³, G Owen⁴⁴, M Garrido⁴⁵, M Diez-García⁴⁶, C Figueiredo⁴⁷, C Caballero²¹, F Lordick⁴⁸, J Farrés⁴⁹, S Derks⁵⁰, F Carneiro⁵¹, A Cervantes⁵², T Fleitas⁵³

Affiliations

¹ Oncology Data Science, Vall d´Hebron Institute of Oncology, Barcelona, Spain; OC Precision Medicine, Oncoclínicas & Co, São Paulo, Brazil; University of Vic-Central University of Catalonia, Barcelona, Spain. Electronic address: https://twitter.com/rdienstmann.
² Departamento de Tumores de Tubo Digestivo, Instituto Nacional de Cancerología, Mexico City, Mexico; Laboratorio de Medicina Traslacional, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/Ruiz-García.
³ Medical Oncology Department, Vall d`Hebron Institute of Oncology, Barcelona, Spain; Hospital Universitario de Navarra, Navarrabiomed-IdiSNA, Pamplona, Spain. Electronic address: https://twitter.com/Alsina.
⁴ Oncology Data Science, Vall d´Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Ruiz-Pace.
⁵ Department of Medical Oncology, Amsterdam University Medical Center (UMC), location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁶ Department of Pathology, Hospital Clínico Universitario de Valencia, Valencia, Spain. Electronic address: https://twitter.com/Martínez-Ciarpaglini.
⁷ Núcleo B de Innovación en Medicina de Precisión, Instituto Nacional de Medicina Genómica, Mexico City, Mexico.
⁸ Department of Pathology, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/Herrera-Goepfert.
⁹ Department of Medical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/Díaz-Romero.
¹⁰ Department of Head of Division, Surgical Pathology, National Cancer Institute (INCan), Mexico City, Mexico. Electronic address: https://twitter.com/Lino-Silva.
¹¹ Department of Gastrointestinal Endoscopy, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/Hernandez-Guerrero.
¹² Laboratorio de Medicina Traslacional, Instituto Nacional de Cancerología, Mexico City, Mexico.
¹³ Departamento de Gastroenterología, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/León-Takahashi.
¹⁴ Department of Gastroenterology and Hepatology, Amsterdam University Medical Center (UMC), location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
¹⁵ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain. Electronic address: https://twitter.com/Romero.
¹⁶ Department of Gastroenterology, Hospital Clínico Universitario de Valencia, Valencia, Spain. Electronic address: https://twitter.com/Villagrasa.
¹⁷ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain. Electronic address: https://twitter.com/Cabeza-Segura.
¹⁸ Department of Pathology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Department of Pathology, Hospital General de Valdepeñas, Valdepeñas, Spain. Electronic address: https://twitter.com/Alarcón-Molero.
¹⁹ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain. Electronic address: https://twitter.com/Jimenez-Martí.
²⁰ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain.
²¹ Department of Pathology, GENPAT, Asunción, Paraguay.
²² Department of Medical Oncology, Instituto de Previsión Social, Asunción, Paraguay.
²³ Department of Pathology, Instituto de Previsión Social, Asunción, Paraguay.
²⁴ Department of Gastroenterology, Instituto de Previsión Social, Asunción, Paraguay.
²⁵ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Vivancos.
²⁶ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Matito.
²⁷ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Martin.
²⁸ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Gómez.
²⁹ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Castillo.
³⁰ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Vila.
³¹ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. Electronic address: https://twitter.com/Ferreira.
³² IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Pathology, Unidade Local de Saúde São João, Porto, Portugal.
³³ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Gastroenterology, Unidade Local de Saúde São João, Porto, Portugal. Electronic address: https://twitter.com/Santos-Antunes.
³⁴ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal. Electronic address: https://twitter.com/Mendes-Rocha.
³⁵ Department of Oncology, Unidade Local de Saúde São João, Porto, Portugal.
³⁶ Department of Respiratory Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
³⁷ Department of Pathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
³⁸ Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
³⁹ Department of Medical Oncology Department, Instituto Alexander Fleming, Buenos Aires, Argentina.
⁴⁰ Department of Gastroenterology, Instituto Alexander Fleming, GEDYT (Gastroenterologia diagnostica y terapeutica), Buenos Aires, Argentina.
⁴¹ Department of Medical Oncology Department, Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: https://twitter.com/federico_esteso.
⁴² Department of Medical Oncology Department, Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: https://twitter.com/juanmaoconnor.
⁴³ Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Center for Prevention and Control of Cancer (CECAN), Santiago, Chile.
⁴⁴ Faculty of Biological Sciences & Faculty of Medicine, Pontificia Universidad Católica de Chile, Millennium Institute for Immunology and Immunotherapy, Center for Prevention and Control of Cancer (CECAN), Advance Center for Chronic Disease (ACCDIS), Santiago, Chile.
⁴⁵ Facultad de Medicina y Ciencia de la Salud, Centro de Oncología de Precision, Universidad Mayor, Santiago, Chile. Electronic address: https://twitter.com/DrGarridoOncoGI.
⁴⁶ Medical Oncology Department, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Diez-García.
⁴⁷ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal. Electronic address: https://twitter.com/FigeuiredoCeu.
⁴⁸ Department of Oncology and University Cancer Center Leipzig, University of Leipzig Medical Center, Leipzig, Germany. Electronic address: https://twitter.com/FlorianLordick.
⁴⁹ Anaxomics Biotech S.L., Barcelona, Spain.
⁵⁰ Department of Medical Oncology, Amsterdam University Medical Center (UMC), location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. Electronic address: https://twitter.com/derks_s.
⁵¹ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Pathology, Unidade Local de Saúde São João, Porto, Portugal. Electronic address: https://twitter.com/Carneiro.
⁵² Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain; Ciberonc, Instituto Carlos III, Madrid, Spain. Electronic address: andres.cervantes@uv.es.
⁵³ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain; Ciberonc, Instituto Carlos III, Madrid, Spain. Electronic address: tfleitas@incliva.es.

PMID: 40036904
PMCID: PMC11926697
DOI: 10.1016/j.esmoop.2025.104482

Integrated clinico-molecular analysis of gastric cancer in European and Latin American populations: LEGACY project

R Dienstmann et al. ESMO Open. 2025 Mar.

. 2025 Mar;10(3):104482.

doi: 10.1016/j.esmoop.2025.104482. Epub 2025 Mar 3.

Authors

Affiliations

¹ Oncology Data Science, Vall d´Hebron Institute of Oncology, Barcelona, Spain; OC Precision Medicine, Oncoclínicas & Co, São Paulo, Brazil; University of Vic-Central University of Catalonia, Barcelona, Spain. Electronic address: https://twitter.com/rdienstmann.
² Departamento de Tumores de Tubo Digestivo, Instituto Nacional de Cancerología, Mexico City, Mexico; Laboratorio de Medicina Traslacional, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/Ruiz-García.
³ Medical Oncology Department, Vall d`Hebron Institute of Oncology, Barcelona, Spain; Hospital Universitario de Navarra, Navarrabiomed-IdiSNA, Pamplona, Spain. Electronic address: https://twitter.com/Alsina.
⁴ Oncology Data Science, Vall d´Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Ruiz-Pace.
⁵ Department of Medical Oncology, Amsterdam University Medical Center (UMC), location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁶ Department of Pathology, Hospital Clínico Universitario de Valencia, Valencia, Spain. Electronic address: https://twitter.com/Martínez-Ciarpaglini.
⁷ Núcleo B de Innovación en Medicina de Precisión, Instituto Nacional de Medicina Genómica, Mexico City, Mexico.
⁸ Department of Pathology, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/Herrera-Goepfert.
⁹ Department of Medical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/Díaz-Romero.
¹⁰ Department of Head of Division, Surgical Pathology, National Cancer Institute (INCan), Mexico City, Mexico. Electronic address: https://twitter.com/Lino-Silva.
¹¹ Department of Gastrointestinal Endoscopy, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/Hernandez-Guerrero.
¹² Laboratorio de Medicina Traslacional, Instituto Nacional de Cancerología, Mexico City, Mexico.
¹³ Departamento de Gastroenterología, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: https://twitter.com/León-Takahashi.
¹⁴ Department of Gastroenterology and Hepatology, Amsterdam University Medical Center (UMC), location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
¹⁵ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain. Electronic address: https://twitter.com/Romero.
¹⁶ Department of Gastroenterology, Hospital Clínico Universitario de Valencia, Valencia, Spain. Electronic address: https://twitter.com/Villagrasa.
¹⁷ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain. Electronic address: https://twitter.com/Cabeza-Segura.
¹⁸ Department of Pathology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Department of Pathology, Hospital General de Valdepeñas, Valdepeñas, Spain. Electronic address: https://twitter.com/Alarcón-Molero.
¹⁹ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain. Electronic address: https://twitter.com/Jimenez-Martí.
²⁰ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain.
²¹ Department of Pathology, GENPAT, Asunción, Paraguay.
²² Department of Medical Oncology, Instituto de Previsión Social, Asunción, Paraguay.
²³ Department of Pathology, Instituto de Previsión Social, Asunción, Paraguay.
²⁴ Department of Gastroenterology, Instituto de Previsión Social, Asunción, Paraguay.
²⁵ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Vivancos.
²⁶ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Matito.
²⁷ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Martin.
²⁸ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Gómez.
²⁹ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Castillo.
³⁰ Cancer Genomics Lab, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Vila.
³¹ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. Electronic address: https://twitter.com/Ferreira.
³² IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Pathology, Unidade Local de Saúde São João, Porto, Portugal.
³³ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Gastroenterology, Unidade Local de Saúde São João, Porto, Portugal. Electronic address: https://twitter.com/Santos-Antunes.
³⁴ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal. Electronic address: https://twitter.com/Mendes-Rocha.
³⁵ Department of Oncology, Unidade Local de Saúde São João, Porto, Portugal.
³⁶ Department of Respiratory Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
³⁷ Department of Pathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
³⁸ Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
³⁹ Department of Medical Oncology Department, Instituto Alexander Fleming, Buenos Aires, Argentina.
⁴⁰ Department of Gastroenterology, Instituto Alexander Fleming, GEDYT (Gastroenterologia diagnostica y terapeutica), Buenos Aires, Argentina.
⁴¹ Department of Medical Oncology Department, Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: https://twitter.com/federico_esteso.
⁴² Department of Medical Oncology Department, Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: https://twitter.com/juanmaoconnor.
⁴³ Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Center for Prevention and Control of Cancer (CECAN), Santiago, Chile.
⁴⁴ Faculty of Biological Sciences & Faculty of Medicine, Pontificia Universidad Católica de Chile, Millennium Institute for Immunology and Immunotherapy, Center for Prevention and Control of Cancer (CECAN), Advance Center for Chronic Disease (ACCDIS), Santiago, Chile.
⁴⁵ Facultad de Medicina y Ciencia de la Salud, Centro de Oncología de Precision, Universidad Mayor, Santiago, Chile. Electronic address: https://twitter.com/DrGarridoOncoGI.
⁴⁶ Medical Oncology Department, Vall d`Hebron Institute of Oncology, Barcelona, Spain. Electronic address: https://twitter.com/Diez-García.
⁴⁷ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal. Electronic address: https://twitter.com/FigeuiredoCeu.
⁴⁸ Department of Oncology and University Cancer Center Leipzig, University of Leipzig Medical Center, Leipzig, Germany. Electronic address: https://twitter.com/FlorianLordick.
⁴⁹ Anaxomics Biotech S.L., Barcelona, Spain.
⁵⁰ Department of Medical Oncology, Amsterdam University Medical Center (UMC), location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. Electronic address: https://twitter.com/derks_s.
⁵¹ IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Pathology, Unidade Local de Saúde São João, Porto, Portugal. Electronic address: https://twitter.com/Carneiro.
⁵² Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain; Ciberonc, Instituto Carlos III, Madrid, Spain. Electronic address: andres.cervantes@uv.es.
⁵³ Department of Medical Oncology, Hospital Clinico Universitario, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia, Spain; Ciberonc, Instituto Carlos III, Madrid, Spain. Electronic address: tfleitas@incliva.es.

PMID: 40036904
PMCID: PMC11926697
DOI: 10.1016/j.esmoop.2025.104482

Abstract

Background: Gastric cancer (GC) is recognized for intrinsic heterogeneity, although it is similarly approached in Europe and Latin America (LATAM). The LEGACY project aimed to deepen GC molecular understanding through multi-omics analysis in Europe and LATAM GC samples.

Patients and methods: Tumor samples were centrally reviewed for histology, human epidermal growth factor receptor 2 (HER2) expression, and mismatch repair-deficient (dMMR)/microsatellite instability (MSI) status. In addition, we assessed Epstein-Barr virus (EBV) status, programmed death-ligand 1 (PD-L1) combined positive score (CPS), and carried out tissue genomic profiling including tumor mutation burden (TMB) quantification plus targeted transcriptomics for immune microenvironment and cancer cell signaling scores.

Results: In total, 328 GC patients were enrolled. HER2-positive GC and high PD-L1 CPS were more frequent in Europe than in LATAM (9% versus 3% and 15% versus 3%, respectively), whereas EBV was mainly found in LATAM (7%, versus 3% in Europe), and dMMR/MSI tumors were equally distributed (16%). High TMB was enriched in dMMR/MSI and EBV tumors. Mutations in homologous recombination repair (HRR) genes were frequent in both cohorts (24.8% and 14.7% in Europe and LATAM, respectively), and mostly found in dMMR/MSI (63.6%) and intestinal HER2-negative (18.7%) tumors. The prognosis was poor in diffuse HER2-negative GC patients, whose tumors presented an immunosuppressive microenvironment and other distinct pathway activation signatures.

Conclusions: Our findings relate specific molecular alterations of GC tumors from Europe and LATAM to actionable biomarkers for precision cancer therapies. The proposed GC stratification can be implemented in routine care and guide drug development strategies.

Keywords: gastric cancer; gastric cancer biomarkers; gastric cancer epidemiology; precision medicine.

PubMed Disclaimer

Figures

**Figure 1**
**LEGACY project summary with samples tracking map and data workflow.** ECPC, European Cancer Patient Coalition, Brussels; eCRF, electronic case report form; GENPAT-IPS, GENPAT laboratory + Instituto de Previsión Social, Paraguay; IAF, Instituto Alexander Fleming, Argentina; IHC, immunohistochemistry; INCAN, Instituto Nacional de Cancerología, Mexico; INCLIVA, Instituto de Investigación Sanitaria INCLIVA, Spain; IPATIMUP, Instituto de Patologia e Imunologia Molecular da Universidade do Porto; ISH, *in situ* hybridization; LATAM: Latin America; PUC, Pontificia Universidad Católica de Chile; ULEI, University of Leipzig, Germany; VHIO, Vall d´ Hebron Institute of Oncology, Spain; VUMC, Vrije Universiteit University Medical Center, The Netherlands.

**Figure 2**
**LEGACY project gastric cancer molecular subtyping with genomic and transcriptomic (immune/pathway) enrichments.** CPS, combined positive score; dMMR, mismatch repair-deficient; EBV, Epstein–Barr virus; HER2, human epidermal growth factor receptor 2; MSI, microsatellite instability; MSS, microsatellite stability; PD-L1, programmed death-ligand 1; pMMR, mismatch repair-proficient; TMB, tumor mutation burden.

**Figure 3**
**LEGACY project molecular data in samples from European (EU) or Latin America (LATAM) countries.** (A) LEGACY molecular subtypes classification. (B) KI67. (C) PD-L1 CPS score in MSS/pMMR samples. (D) TMB counts in MSS/pMMR samples. CPS, combined positive score; dMMR, mismatch repair-deficient; EBV, Epstein–Barr virus; HER2, human epidermal growth factor receptor 2; MSI, microsatellite instability; MSS, microsatellite stability; PD-L1, programmed death-ligand 1; pMMR, mismatch repair-proficient; TMB, tumor mutation burden.

**Figure 4**
**Transcriptomic enrichments in LEGACY project gastric cancer molecular subtyping.** dMMR, mismatch repair-deficient; EBV, Epstein–Barr virus; HER2, human epidermal growth factor receptor 2; MSI, microsatellite instability; TGF, transforming growth factor.

See this image and copyright information in PMC

References

1. Shitara K., Fleitas T., Kawakami H., et al. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with gastric cancer. ESMO Open. 2024;9(2) - PMC - PubMed
1. Bray F., Laversanne M., Sung H., et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–263. - PubMed
1. Pectasides E., Stachler M.D., Derks S., et al. Genomic heterogeneity as a barrier to precision medicine in gastroesophageal adenocarcinoma. Cancer Discov. 2018;8(1):37–48. - PMC - PubMed
1. Alsina M., Arrazubi V., Diez M., Tabernero J. Current developments in gastric cancer: from molecular profiling to treatment strategy. Nat Rev Gastroenterol Hepatol. 2023;20(3):155–170. - PubMed
1. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 1965;64:31–49. - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions
Actions

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Integrated clinico-molecular analysis of gastric cancer in European and Latin American populations: LEGACY project

Affiliations

Integrated clinico-molecular analysis of gastric cancer in European and Latin American populations: LEGACY project

Authors

Affiliations

Abstract

Figures

References

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Miscellaneous