Molecular biology of sporadic gastric cancer: prognostic indicators and novel therapeutic approaches.
Both the availability of multiple treatment modalities and novel therapeutic targets make the correct prognostic stratification and the identification of truly predictive factors an issue of major debate in gastric cancer. Along with "classic" prognostic factors such as those related to the diffusion of the tumour at diagnosis (i.e., depth of gastric wall infiltration, locoregional lymph nodes or distant metastases) or those concerning the pathologic characteristics of the tumour, other, innovative, factors should be considered if a better definition of the characteristics of the tumour is to be given. These biological factors are often derived from the genetic process, which is thought to represent a crucial step to gastric cancer (DNA copy number changes, microsatellite instability, thymidilate synthase, E-cadherin, beta-catenin, mucin antigen, p53, c-erb B-2, COX-2, matrix metalloproteinases, VEGFR and EGFR). Some of those putative prognostic indicators can also be considered predictive of response to therapy as they are a molecular target either to chemotherapeutics (i.e., thymidilate synthase that is targeted by 5FU) or to a new class of antineoplastic molecules (i.e., c-erb B-2 targeted by trastuzumab, COX-2 by NSAIDs, matrix metalloproteinases, EGFR and VEGFR by specific inhibitors).
Scartozzi
Mario
M
Clinica di Oncologia Medica, Università Politecnica delle Marche-Azienda Ospedaliera Umberto I, Ancona, Italy.
Galizia
Eva
E
Freddari
Federica
F
Berardi
Rossana
R
Cellerino
Riccardo
R
Cascinu
Stefano
S
D017209:Apoptosis; D051546:Cyclooxygenase 2; D066246:ErbB Receptors / Q000502:physiology; D018628:Gene Dosage; D018734:Genes, erbB-2; D016158:Genes, p53; D005819:Genetic Markers; D006801:Humans; D007527:Isoenzymes / Q000187:drug effects / Q000494:pharmacology; D020782:Matrix Metalloproteinases / Q000494:pharmacology; D008562:Membrane Glycoproteins / Q000502:physiology*; D008565:Membrane Proteins; D018895:Microsatellite Repeats; D011379:Prognosis; D011451:Prostaglandin-Endoperoxide Synthases / Q000187:drug effects / Q000494:pharmacology; D013274:Stomach Neoplasms / Q000235:genetics* / Q000503:physiopathology*; D013940:Thymidylate Synthase / Q000187:drug effects / Q000494:pharmacology
D005819:Genetic Markers; D007527:Isoenzymes; D008562:Membrane Glycoproteins; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D013940:Thymidylate Synthase; D066246:ErbB Receptors; D020782:Matrix Metalloproteinases