Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer

Gastric & Breast Cancer e-journal
DOI: 10.2122/gbc.2012.0225


Predictive molecular tools to personalized gastric cancer  targeted therapy.

Edwin Sandanaraj, PhD and Joanna Holbrook, PhD.

Affiliation: (ES) and (JH) both from Singapore Institute of Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609.


Trastuzumab has been the first targeted agent approved by the FDA for the first line treatment of ERBB2-positive advanced gastric cancer patients. This anti-HER2 drug provides evidence for significant overall survival benefit. However, the ERRB2 signalling pathways activation has been seen observed in only about 7-25% of gastric cancer patients with no trastuzumab antitumor activity for the remaining ERBB2-negative proportion. Large-scale clinical trials such as the TOGA and AVAGAST have explored prognostic biomarker identification to enhance clinical outcome. However, the high level of genetic and molecular heterogeneity within gastric tumours, across time, across patients and across geographical regions remains a substantial challenge. Characterization of activated signalling pathways that is crucial for both biomarkers development and drugs selection, in individual patients still remains a grand challenge. In this review, we evaluate the profiling of oncogenic pathways that is likely to confer sensitivity to available targeted therapies. Advances and challenges are discussed.

(Citation: Gastric & Breast Cancer 2012; 11(3) 166-179).



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last update: 10 July 2012