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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2016; 22(26): 5896-5908
Published online Jul 14, 2016. doi: 10.3748/wjg.v22.i26.5896
Exploring the role of molecular biomarkers as a potential weapon against gastric cancer: A review of the literature
Marwa Matboli, Sarah El-Nakeep, Nourhan Hossam, Alaa Habieb, Ahmed E M Azazy, Ali E Ebrahim, Ziad Nagy, Omar Abdel-Rahman
Marwa Matboli, Nourhan Hossam, Alaa Habieb, Oncology Diagnostic Unit, Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Ain Shams University, Cairo 113331, Egypt
Sarah El-Nakeep, Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo 113331, Egypt
Ali E Ebrahim, Ziad Nagy, Ahmed EM Azazy, Armed Forces College of Medicine, Cairo 113331, Egypt
Omar Abdel-Rahman, Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo 113331, Egypt
Author contributions: Matboli M and El-Nakeep S planned the study and drafted the review; HossamN, Habieb A, Azazy AEM, Ebrahim AE and Nagy Z have collected the data and drafted the review; Abdel-Rahman O has revised the review and analyzed the collected literature.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Omar Abdel-Rahman, Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo 113331, Egypt. omar.abdelrhman@med.asu.edu.eg
Telephone: +2-100-8541806 Fax: +2-100-26858397
Received: March 15, 2016
Peer-review started: March 18, 2016
First decision: May 12, 2016
Revised: May 25, 2016
Accepted: June 13, 2016
Article in press: June 13, 2016
Published online: July 14, 2016
Abstract

Gastric cancer (GC) is a global health problem and a major cause of cancer-related death with high recurrence rates ranging from 25% to 40% for GC patients staging II-IV. Unfortunately, while the majority of GC patients usually present with advanced tumor stage; there is still limited evidence-based therapeutic options. Current approach to GC management consists mainly of; endoscopy followed by, gastrectomy and chemotherapy or chemo-radiotherapy. Recent studies in GC have confirmed that it is a heterogeneous disease. Many molecular characterization studies have been performed in GC. Recent discoveries of the molecular pathways underlying the disease have opened the door to more personalized treatment and better predictable outcome. The identification of molecular markers is a useful tool for clinical managementin GC patients, assisting in diagnosis, evaluation of response to treatment and development of novel therapeutic modalities. While chemotherapeutic agents have certain physiological effects on the tumor cells, the prediction of the response is different from one type of tumor to the other. The specificity of molecular biomarkers is a principal feature driving their application in anticancer therapies. Here we are trying to focus on the role of molecular pathways of GC and well-established molecular markers that can guide the therapeutic management.

Keywords: Gastric cancer, Molecular therapy, Targeted therapy, Biomarkers, Bioinformatics

Core tip: We tried to highlight the role of molecular biomarkers as a predictor to chemotherapeutic response to existing regimens, aiming for better personalized therapy. Also we provided a summary of molecular markers that may aid in the development of rational therapeutic options for gastric cancer (GC) patients, aiming for improving their outcomes. However, among the plethora of agents targeting VEGF, EGFR, HER-2, IGF and mTOR pathways, trastuzumab and ramucirumab have been the only approved therapeutic options for use in advanced GC. Despite having many promising studies in their early stages, a lot have failed to prove their effectiveness in GC on the long run.