title: Personalised Treatment in Gastric Cancer: Myth or Reality?
abstract: Despite recent diagnostic and therapeutic advances, the survival of patients with gastric cancer is still poor. The majority of patients are diagnosed with advanced disease and chemotherapy represents the only possible therapeutic approach. However, chemotherapy seems to have reached an efficacy plateau in this setting. Gastric cancer is a complex and heterogeneous disease because it emerges from multiple interactions of genetic, environmental and host factors. A better understanding of its molecular characteristics may lead to an improvement of outcomes. The recent molecular classification by The Cancer Genome Atlas project divides gastric cancer into four subtypes that could be taken into consideration in future clinical trials with targeted agents. So far trastuzumab, a monoclonal antibody addressing the HER2 receptor, is the only targeted agent approved in the first-line setting, but only in patients overexpressing HER2. Negative data have been obtained in first-line therapy when antiangiogenics, anti-EGFR or anti-MET monoclonal antibodies have been studied in randomised controlled trials. Ramucirumab, a monoclonal antibody binding to VEGFR2, is the only antiangiogenic agent currently recommended in patients progressing after first-line treatment. In this review, we discuss whether personalised therapy may have a role in gastric cancer.
authors.affiliation: Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain.|Rio Hortega Contract CM15/00246, Valencia, Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Tarazona
authors.affiliation: Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain.|ESMO Translational Research Fellow, Valencia, Spain.
authors.forename: Valentina
authors.initials: V
authors.lastname: Gambardella
authors.affiliation: Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain.
authors.forename: Marisol
authors.initials: M
authors.lastname: Huerta
authors.affiliation: Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Roselló
authors.affiliation: Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain. andres.cervantes@uv.es.
authors.forename: Andrés
authors.initials: A
authors.lastname: Cervantes
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006801:Humans; D058990:Molecular Targeted Therapy; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors*; D057285:Precision Medicine; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000378:metabolism*
chemical_list: D000970:Antineoplastic Agents; D009363:Neoplasm Proteins
keywords: Biomarkers; Clinical trial; Gastric cancer; Molecular classification; Patient selection; Targeted therapy; Trastuzumab