title: Personalized medicine in gastric cancer: Where are we and where are we going?
abstract: Despite improvements in adjuvant therapies for gastric cancer in recent years, the disease is characterized by high recurrence rates and a dismal prognosis. The major improvement in the treatment of recurrent or metastatic gastric cancer in recent years has been the incorporation of trastuzumab, a monoclonal antibody that inhibits human epidermal growth factor receptor 2 (HER2) heterodimerization, after the demonstrated predictive value of the overexpression and/or amplification of this receptor. Beyond HER2, other genetic abnormalities have been identified, and these mutations may be targetable by tyrosine kinase inhibitors or monoclonal antibodies. The demonstration of four distinct molecular subtypes of gastric cancer by the Cancer Genome Atlas study highlight the enormous heterogeneity of the disease and its complex interplay between genetic and epigenetic alterations and provide a roadmap to implement genome-guided personalized therapy in gastric cancer. In the present review, we aim to discuss, from a clinical point of view, the genomic landscape of gastric cancer described in recent studies, the therapeutic insights derived from these findings, and the clinical trials that have been conducted and those in progress that take into account tailored therapies for gastric cancer.
authors.affiliation: Alexandre A Jácome, Enaldo M Lima, Aline C Andrade, Department of Medical Oncology, Hospital Mater Dei, Belo Horizonte 30190-131, Minas Gerais, Brazil.
authors.forename: Alexandre A
authors.initials: AA
authors.lastname: Jácome
authors.affiliation: Alexandre A Jácome, Enaldo M Lima, Aline C Andrade, Department of Medical Oncology, Hospital Mater Dei, Belo Horizonte 30190-131, Minas Gerais, Brazil.
authors.forename: Anelisa K
authors.initials: AK
authors.lastname: Coutinho
authors.affiliation: Alexandre A Jácome, Enaldo M Lima, Aline C Andrade, Department of Medical Oncology, Hospital Mater Dei, Belo Horizonte 30190-131, Minas Gerais, Brazil.
authors.forename: Enaldo M
authors.initials: EM
authors.lastname: Lima
authors.affiliation: Alexandre A Jácome, Enaldo M Lima, Aline C Andrade, Department of Medical Oncology, Hospital Mater Dei, Belo Horizonte 30190-131, Minas Gerais, Brazil.
authors.forename: Aline C
authors.initials: AC
authors.lastname: Andrade
authors.affiliation: Alexandre A Jácome, Enaldo M Lima, Aline C Andrade, Department of Medical Oncology, Hospital Mater Dei, Belo Horizonte 30190-131, Minas Gerais, Brazil.
authors.forename: José Sebastião
authors.initials: JS
authors.lastname: Dos Santos
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics* / Q000378:metabolism / Q000401:mortality; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics* / Q000378:metabolism; D044127:Epigenesis, Genetic; D020022:Genetic Predisposition to Disease; D006801:Humans; D025202:Molecular Diagnostic Techniques; D058990:Molecular Targeted Therapy; D009154:Mutation; D018579:Patient Selection; D010641:Phenotype; D057285:Precision Medicine; D011237:Predictive Value of Tests; D012307:Risk Factors; D015398:Signal Transduction / Q000187:drug effects; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000378:metabolism / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
keywords: Biological markers; Individualized medicine; Molecular targeted therapy; Stomach neoplasms; Transcriptome
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