Published online Nov 15, 2015. doi: 10.4251/wjgo.v7.i11.292
Peer-review started: May 7, 2015
First decision: June 25, 2015
Revised: July 23, 2015
Accepted: September 30, 2015
Article in press: October 10, 2015
Published online: November 15, 2015
Gastric cancer is one of the most common malignancies worldwide. The overall prognosis remains poor over the last decades even though improvements in surgical outcomes have been achieved. A better understanding of the molecular biology of gastric cancer and detection of eligible molecular targets might be of central interest to further improve clinical outcome. With this intention, first steps have been made in the research of growth factor signaling. Regarding morphogens, cell cycle and nuclear factor-κB signaling, a remarkable count of target-specific agents have been developed, nevertheless the transfer into the field of clinical routine is still at the beginning. The potential utility of epigenetic targets and the further evaluation of microRNA signaling seem to have potential for the development of novel treatment strategies in the future.
Core tip: Advanced gastric cancer remains a frequent malignancy with poor prognosis despite multimodal treatment options. Surgery alone has been demonstrated not to be the optimal strategy and is predominantly limited to cases without distant metastases. About one half of gastric cancer patients cannot be cured. Due to its individual heterogeneity on the molecular level these tumors frequently do not respond to systemic treatment. The implementation of the growing knowledge about the molecular behavior of gastric cancer in the development or improvement of target-specific treatment strategies might be one of the major challenges for the next decades.