Published online Oct 21, 2015. doi: 10.3748/wjg.v21.i39.10948
Peer-review started: May 11, 2015
First decision: June 23, 2015
Revised: July 9, 2015
Accepted: August 30, 2015
Article in press: August 30, 2015
Published online: October 21, 2015
Processing time: 166 Days and 19 Hours
Gastric cancer is the fourth most common type of cancer and represents a major cause of cancer-related deaths worldwide. With recent biomedical advances in our understanding of the molecular characteristics of gastric cancer, many genetic alterations have been identified as potential targets for its treatment. Multiple novel agents are currently under development as the demand for active agents that improve the survival of gastric cancer patients constantly increases. Based on lessons from previous trials of targeted agents, it is now widely accepted that the establishment of an optimal diagnostic test to select molecularly defined patients is of equal importance to the development of active agents against targetable genetic alterations. Herein, we highlight the current status and future perspectives of companion diagnostics in the treatment of gastric cancer.
Core tip: Companion diagnostics are in vitro clinical laboratory assays designed to predict the efficacy of treatment using biomarker-based assessments. For patients with gastric cancer, immunohistochemistry for human epidermal growth factor receptor 2 (HER2) overexpression and fluorescence in situ hybridization for HER2 amplification are the only approved companion diagnostic devices. In this era of targeted therapy, the concurrent development of companion diagnostic techniques is critical for the success of novel therapeutics. Furthermore, the successful co-development of drug and companion diagnostics requires a thorough molecular understanding of both tumor biology and the mechanisms of drug actions.