3 Stomach Cancer Subtypes That Should Be Treated Differently

Stomach cancer falls into three broad subtypes that respond differently to currently available therapies, according to a new study.

Asian Scientist (Aug. 28, 2013) – Stomach cancer, one of the leading causes of cancer death worldwide, actually falls into three broad subtypes that respond differently to currently available therapies, according to researchers at Duke-NUS Graduate Medical School Singapore.

The finding, published in Gastroenterology, could greatly improve patient care with the development of a genetic test to classify tumors and match them to the therapies that offer the best outcomes.

“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,” said Professor Steve Rozen, senior author of the study.

“What our study has shown is that there are actually three distinct molecular classifications that appear to be biologically and therapeutically meaningful.”

Despite differences in the way their tumors respond to treatments, patients often receive a “one-size-fits-all” treatment approach, resulting in poor survival rates.

The researchers analyzed the gene expression profiles of 248 gastric tumors and grouped them according to the genes that were expressed in the tumors.

The gene expression analysis broadly sorts the tumors into three subtypes that are designated proliferative, metabolic and mesenchymal, respectively.

Apart from having different gene expression profiles, the researchers showed that these subtypes also differ in their responses to treatment using current anti-cancer therapies.

“In terms of clinical treatment, there are two promising findings from our research,” said Professor Rozen. “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 Dr Zhengdeng Lei, lead author of the study.

The article can be found at: Lei et al. (2013) Identification Of Molecular Subtypes Of Gastric Cancer With Different Responses To PI3-Kinase Inhibitors And 5-Fluorouracil.


Source: Duke-NUS; Photo: TipsTimes/Flickr/CC.
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