title: [Pharmacogenomics of the first-line treatment for gastric cancer: advances in the identification of genomic biomarkers for clinical response to chemotherapy].
abstract: Gastric cancer (GC) is often diagnosed at later stages due to the lack of specificity of symptoms associated with the neoplasm, causing high mortality rates worldwide. The first line of adjuvant and neoadjuvant treatment includes cytotoxic fluoropyrimidines and platin-containing compounds which cause the formation of DNA adducts. The clinical outcome with these antineoplastic agents depends mainly on tumor sensitivity, which is conditioned by the expression level of the drug targets and the DNA-repair system enzymes. In addition, some germ line polymorphisms, in genes linked to drug metabolism and response to chemotherapy, have been associated with poor responses and the development of adverse effects, even with fatal outcomes in GC patients. The identification of genomic biomarkers, such as individual gene polymorphisms or differential expression patterns of specific genes, in a patient-by-patient context with potential clinical application is the main focus of current pharmacogenomic research, which aims at developing a rational and personalized therapy (i.e., a therapy that ensures maximum efficacy with no predictable side effects). However, because of the future application of genomic technologies in the clinical setting, it is necessary to establish the prognostic value of these genomic biomarkers with genotype-phenotype association studies and to evaluate their prevalence in the population under treatment. These issues are important for their cost-effectiveness evaluation, which determines the feasibility of using these medical genomic research products for GC treatment in the clinical setting.
authors: Carlos
authors: C
authors: Castro-Rojas
authors: Rocío
authors: R
authors: Ortiz-Lópezj
authors: Augusto
authors: A
authors: Rojas-Martínez
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000145:classification / Q000493:pharmacokinetics*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001692:Biological Transport / Q000235:genetics; D015415:Biomarkers; D001711:Biotransformation / Q000235:genetics; D000069287:Capecitabine; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D004338:Drug Combinations; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D004798:Enzymes / Q000235:genetics; D005006:Ethnicity / Q000235:genetics; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D005743:Gastrectomy; D006801:Humans; D008800:Mexico; D058990:Molecular Targeted Therapy; D009944:Organoplatinum Compounds / Q000493:pharmacokinetics; D010094:Oxonic Acid / Q000493:pharmacokinetics; D018579:Patient Selection; D010597:Pharmacogenetics; D057285:Precision Medicine; D011355:Prodrugs / Q000493:pharmacokinetics; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000601:surgery; D005641:Tegafur / Q000493:pharmacokinetics
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D004338:Drug Combinations; D004798:Enzymes; D009944:Organoplatinum Compounds; D011355:Prodrugs; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000069287:Capecitabine; D005472:Fluorouracil