Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2020; 12(1): 1-20
Published online Jan 15, 2020. doi: 10.4251/wjgo.v12.i1.1
Precision medicine for gastrointestinal cancer: Recent progress and future perspective
Tasuku Matsuoka, Masakazu Yashiro
Tasuku Matsuoka, Masakazu Yashiro, Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka 5458585, Japan
Masakazu Yashiro, Oncology Institute of Geriatrics and Medical Science, Osaka City University Graduate School of Medicine, Osaka 5458585, Japan
Author contributions: Matsuoka T and Yahiro M performed literature research; Matsuoka T wrote the manuscript and performed the revision and approval of the final version; Yahiro M designed research, coordinated and corrected the writing of the paper.
Supported by KAKENHI (Grant-in-Aid for Scientific Research), No. 18H02883.
Conflict-of-interest statement: There are not any financial or other interests regarding the submitted manuscript that might be construed as a conflict 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:
Corresponding author: Masakazu Yashiro, MD, PhD, Associate Professor, Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 5458585, Japan.
Received: March 14, 2019
Peer-review started: March 15, 2019
First decision: July 31, 2019
Revised: October 12, 2019
Accepted: November 4, 2019
Article in press: November 4, 2019
Published online: January 15, 2020

Gastrointestinal (GI) cancer has a high tumor incidence and mortality rate worldwide. Despite significant improvements in radiotherapy, chemotherapy, and targeted therapy for GI cancer over the last decade, GI cancer is characterized by high recurrence rates and a dismal prognosis. There is an urgent need for new diagnostic and therapeutic approaches. Recent technological advances and the accumulation of clinical data are moving toward the use of precision medicine in GI cancer. Here we review the application and status of precision medicine in GI cancer. Analyses of liquid biopsy specimens provide comprehensive real-time data of the tumor-associated changes in an individual GI cancer patient with malignancy. With the introduction of gene panels including next-generation sequencing, it has become possible to identify a variety of mutations and genetic biomarkers in GI cancer. Although the genomic aberration of GI cancer is apparently less actionable compared to other solid tumors, novel informative analyses derived from comprehensive gene profiling may lead to the discovery of precise molecular targeted drugs. These progressions will make it feasible to incorporate clinical, genome-based, and phenotype-based diagnostic and therapeutic approaches and apply them to individual GI cancer patients for precision medicine.

Keywords: Gastrointestinal cancer, Esophageal cancer, Gastric cancer, Colorectal cancer, Precision medicine, Liquid biopsy, Gene panel, Precision surgery, Biomarkers

Core tip: Gastrointestinal (GI) cancer is one of the most common leading causes of cancer death worldwide. Hence, any effort in early diagnosis, choice of appropriate therapeutic strategies can have a pivotal role in reducing the disease related mortalities. Our review purpose to clarify the current advancement for precision medicine in GI cancer by elucidating the benefit of liquid biopsy, multiple gene panel, novel biomarkers and surgery in GI cancer.