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Biomarkers for gastric cancer: prognostic, predictive or targets of therapy?

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Abstract

Gastric cancer is an aggressive disease often diagnosed at an advanced stage. Despite improvements in surgical and adjuvant treatment approaches, gastric cancer remains a global public health problem with a 5-year overall survival of less than 25 %. This is a heterogeneous disease, both in terms of biology and genetics, and many prognostic biomarkers have been pointed out in the literature; nevertheless, their application remains debatable. In this review, we opted to give relevance to those biomarkers that have been the subject of studies with significant statistical power, which have been replicated and have been/are in targeted therapy clinical trials and, which as a consequence, have their prognostic and/or predictive value established. Some gastric cancer biomarkers that may help in defining the course of treatment are also discussed. Accepted practical guidelines, wet-lab protocols for the detection of these biomarkers, as well as ongoing and completed clinical trials have been compiled. In summary, clinical approaches based on the combination of correct staging with targeted and conventional systemic therapies may improve gastric cancer patients’ outcome, but are only in their infancy. Some major challenges in identifying reliable prognostic/predictive biomarkers are individual genetic variation and tumour heterogeneity that often influence response to therapy and drug resistance. Prognostic and predictive biomarkers may nevertheless be extremely valuable to correctly stratify gastric cancer patients for treatment and, ultimately, improve survival.

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Acknowledgments

The salary support to CD and GMA from POPH-QREN/Type 4.1, European Social Fund and Portuguese Ministry of Science and Technology (MCTES), SFRH/BPD/62974/2009 and SFRH/BPD/87257/2012, respectively, is acknowledged. IPATIMUP is an Associate Laboratory of the Portuguese Ministry of Science, Technology and Higher Education and is partially supported by FCT, the Portuguese Foundation for Science and Technology.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal

    Cecília Durães, Gabriela M. Almeida, Raquel Seruca, Carla Oliveira & Fátima Carneiro

  2. Pathology and Oncology Department, Faculty of Medicine of the University of Porto, Porto, Portugal

    Raquel Seruca, Carla Oliveira & Fátima Carneiro

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  1. Cecília Durães
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  2. Gabriela M. Almeida
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  3. Raquel Seruca
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  4. Carla Oliveira
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  5. Fátima Carneiro
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Correspondence to Carla Oliveira or Fátima Carneiro.

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Durães, C., Almeida, G.M., Seruca, R. et al. Biomarkers for gastric cancer: prognostic, predictive or targets of therapy?. Virchows Arch 464, 367–378 (2014). https://doi.org/10.1007/s00428-013-1533-y

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  • DOI: https://doi.org/10.1007/s00428-013-1533-y

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