Molecular subtype based precision cancer medicine for gastric cancer

Jae-Ho Cheong

Department of Surgery and Department of Biomedical Systems informatics,

Yonsei University College of Medicine, Seoul,03722 Korea

Recent molecular classification of solid cancers has identified subtypes which have distinct driver genomic alterations and biological processes reflected on transcriptome profiles. A deeper understanding of the molecular basis of cancer subtypes might lead to new classes of therapies that selectively target aberrant molecular mechanisms that are crucial for the survival and proliferation of cancer cells. Moreover, identifying molecular subtypes related to therapy responsiveness for cytotoxic and targeted therapies that have been used for many years will facilitate a more stratified and rationalized approaches to current standard of care. Here I will discuss the patient-centric development of precision medicine clinical translational platform that will incorporate the power of molecular subtyping of large scale transcriptome analysis that identifies distinct subtypes of GC. Careful assessment of GC patients’ molecular tributes to assign each patient into appropriate subgroup will guide genomic information driven precision medicine. Moreover, patients with “chemorefractory” subtype might be benefited from alternative therapeutic approaches based on their potential driver pathways while spared from ineffective current standard chemotherapy only causing debilitating side effects. For refractory cancers such as recurrent tumors, appropriate therapeutic strategy should be sought to improve survival and to achieve durable responses.

Collectively, clinical development of molecular assays to identify tumor subtypes related to clinical outcome and therapy responsiveness and to test subtype-specific therapies may contribute to implementation of precision cancer medicine.