Commentary


A new molecular classification of gastric cancer proposed by Asian Cancer Research Group (ACRG)

Yingyan Yu

Abstract

The data released from World Health Organization (WHO) show that 989,600 new cases of gastric cancer per year occurred globally and more than half of the patients happened in East Asia. Among them, more than 400,000 cases per year of gastric cancer occurred in China, occupying about 40% of new cases in the world. Apparently, gastric cancer has become a big killer for Asian people. At present, a specific targeted therapy for gastric carcinoma is lack. Many patients still get homogeneous (one-size-fits-all) treatment, that is, surgical resection followed by conventional chemotherapy. In clinical practice, we usually encountered that the patients underwent same regimen, but their clinical outcomes are significantly different at same clinical TNM staging (tumor, node, metastasis). Some tumors are sensitive to regimen, but others do not have responses. The reason is related to tumor heterogeneity. Heterogeneity of gastric cancer can be reflected to their origin, such as cardia, body and antrum of the stomach. The heterogeneity of gastric cancer is also related to histological variances of stomach tumor, such as histological phenotypes of papillary carcinomas, tubular adenocarcinoma, signet-ring cell carcinoma, mucinous carcinomas, and so on.