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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2018; 24(18): 1942-1961
Published online May 14, 2018. doi: 10.3748/wjg.v24.i18.1942
New therapeutic options opened by the molecular classification of gastric cancer
Mihaela Chivu-Economescu, Lilia Matei, Laura G Necula, Denisa L Dragu, Coralia Bleotu, Carmen C Diaconu
Mihaela Chivu-Economescu, Lilia Matei, Laura G Necula, Denisa L Dragu, Coralia Bleotu, Carmen C Diaconu, Department of Cellular and Molecular Pathology, Stefan S. Nicolau Institute of Virology, Bucharest 030304, Romania
Laura G Necula, Nicolae Cajal Institute, Titu Maiorescu University, Bucharest 040441, Romania
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature analysis, drafting and critical revision, and approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
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: Mihaela Chivu-Economescu, PhD, Senior Researcher, Department of Cellular and Molecular Pathology, Stefan S. Nicolau Institute of Virology, 285 Mihai Bravu Ave, Bucharest 030304, Romania. mihaela.economescu@virology.ro
Telephone: +40-21-3242590 Fax: +40-21-3242590
Received: March 19, 2018
Peer-review started: March 20, 2018
First decision: April 10, 2018
Revised: April 12, 2018
Accepted: April 23, 2018
Article in press: April 23, 2018
Published online: May 14, 2018
Core Tip

Core tip: A new molecular classification of gastric cancer (GC) became available after publication of three landmark studies: The Cancer Genome Atlas, “Singapore-Duke” study, and Asian Cancer Research Group, allowing patient selection for specific targeted therapy. The Epstein-Barr virus positive, microsatellite stable TP53-active or microsatellite-unstable tumors subtypes presents tumour infiltrating patterns with overexpression of PD-1, PD-L1, PDL-2. Preliminary data show high response rate to immunotherapy and open new avenues to gene therapy. Currently effective therapies for diffuse GC are lacking. Mutations in e-cadherin and Ras homolog family member A genes, or Claudin-18-ARHGAP6/26 fusions may be exploited as therapeutic targets. The only targeted therapies approved so far for chromosomal instability and microsatellite stable TP53-inactive subtypes of GC are trastuzumab and ramucirumab (HER2 and VEGFR2 inhibitors).