Different Subtypes of Gastric Cancer May Require Different Treatments

A recent study looks in-depth at three broad subtypes of gastric cancer and the different treatments required for the health issues.  

According to researchers at Duke-NUS Graduate Medical School Singapore, this could help lead to the development of better genetic testing to classify tumors and match them to therapies that may offer better outcomes for patients.

"One of the features that makes gastric cancer so lethal is that it arises from many genetic alterations, creating differences in how the tumors respond to therapies," Steve Rozen, Ph.D., director of the Centre for Computational Biology at Duke-NUS. Rozen is senior author of the study said, via a press release. "What our study has shown is that there are actually three distinct molecular classifications that appear to be biologically and therapeutically meaningful."

Background information from the study shows that worldwide, only lung cancer is more lethal than stomach cancer, and despite that rates for these malignancies have been dropping more, over 21,000 in the United States alone are still affected by the problem, according to the National Cancer Institute.

Many blame the spread of cancerous tumors to patients receiving a "one-size-fits-all" treatment.

"There has been an urgent need for improved classification of gastric cancer that provides insight into the biology of the tumors that might help predict treatment response," said co-senior author Patrick Tan, M.D., PhD., professor in the Cancer and Stem Cell Biology Program at Duke-NUS, via the release.

The researchers used a technology known as microarray-based gene expression to analyze 248 gastric tumors, sorting the tumors into the following three subtypes: proliferative, metabolic and mesenchymal.

"In terms of clinical treatment, there are two promising findings from our research," Rozen said, via the release. "One is that 5-FU has been particularly effective against metabolic- subtype tumors, and the second is that drugs targeting the PI3K-AKT-mTOR pathway may be particularly effective against mesenchymal-subtype cancers."

"If confirmed in future studies, the classification of gastric cancers reported here could guide development of therapies tailored to the molecular subtypes," said lead author Zhengdeng Lei, PhD.

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More information regarding the study can be found via the journal Gastroenterology.