J Gastric Cancer.  2019 Sep;19(3):235-253. 10.5230/jgc.2019.19.e25.

Clinical Implementation of Precision Medicine in Gastric Cancer

  • 1Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. JHCHEONG@yuhs.ac
  • 3Yonsei Biomedical Research Institute, Yonsei University College of Medicine, Seoul, Korea.
  • 4Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Biochemistry & Molecular Biology, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea.


Gastric cancer (GC) is one of the deadliest malignancies in the world. Currently, clinical treatment decisions are mostly made based on the extent of the tumor and its anatomy, such as tumor-node-metastasis staging. Recent advances in genome-wide molecular technology have enabled delineation of the molecular characteristics of GC. Based on this, efforts have been made to classify GC into molecular subtypes with distinct prognosis and therapeutic response. Simplified algorithms based on protein and RNA expressions have been proposed to reproduce the GC classification in the clinical field. Furthermore, a recent study established a single patient classifier (SPC) predicting the prognosis and chemotherapy response of resectable GC patients based on a 4-gene real-time polymerase chain reaction assay. GC patient stratification according to SPC will enable personalized therapeutic strategies in adjuvant settings. At the same time, patient-derived xenografts and patient-derived organoids are now emerging as novel preclinical models for the treatment of GC. These models recapitulate the complex features of the primary tumor, which is expected to facilitate both drug development and clinical therapeutic decision making. An integrated approach applying molecular patient stratification and patient-derived models in the clinical realm is considered a turning point in precision medicine in GC.


Stomach neoplasm; Precision medicine; Tumor biomarkers; Adjuvant chemotherapy; Molecular targeted therapy

MeSH Terms

Biomarkers, Tumor
Chemotherapy, Adjuvant
Decision Making
Drug Therapy
Molecular Targeted Therapy
Precision Medicine*
Real-Time Polymerase Chain Reaction
Stomach Neoplasms*
Biomarkers, Tumor
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