Topic Highlight
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2015; 7(11): 292-302
Published online Nov 15, 2015. doi: 10.4251/wjgo.v7.i11.292
Individualized treatment of gastric cancer: Impact of molecular biology and pathohistological features
Yves Dittmar, Utz Settmacher
Yves Dittmar, Utz Settmacher, Department of General, Visceral and Vascular Surgery, University Hospital Jena, 07745 Jena, Germany
Author contributions: Dittmar Y compiled and analyzed data and wrote the paper; Settmacher U reviewed the paper and provided valuable scientific input.
Conflict-of-interest statement: The authors declare no 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:
Correspondence to: Yves Dittmar, MD, Department of General, Visceral and Vascular Surgery, University Hospital Jena, Erlanger Allee 101, 07745 Jena, Germany.
Telephone: +49-3641-9322601 Fax: +49-3641-9322602
Received: April 29, 2015
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.

Keywords: Gastric cancer, Molecular biology, Targeted therapy, Personalized medicine, Signaling pathway

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.