Gastric cancer: a comprehensive review of current and future treatment strategies
CANCER AND METASTASIS REVIEWS
Authors: Sexton, Rachel E.; Al Hallak, Mohammed Najeeb; Diab, Maria; Azmi, Asfar S.
Gastric cancer remains a major unmet clinical problem with over 1 million new cases worldwide. It is the fourth most commonly occurring cancer in men and the seventh most commonly occurring cancer in women. A major fraction of gastric cancer has been linked to variety of pathogenic infections including but not limited to Helicobacter pylori (H. pylori) or Epstein Barr virus (EBV). Strategies are being pursued to prevent gastric cancer development such asH. pylorieradication, which has helped to prevent significant proportion of gastric cancer. Today, treatments have helped to manage this disease and the 5-year survival for stage IA and IB tumors treated with surgery are between 60 and 80%. However, patients with stage III tumors undergoing surgery have a dismal 5-year survival rate between 18 and 50% depending on the dataset. These figures indicate the need for more effective molecularly driven treatment strategies. This review discusses the molecular profile of gastric tumors, the success, and challenges with available therapeutic targets along with newer biomarkers and emerging targets.
Epstein-Barr virus infection and genome polymorphisms on gastric remnant carcinoma: a meta-analysis
CANCER CELL INTERNATIONAL
Authors: Lu, Chao; Zhang, Hongtao; Zhou, Weihua; Wan, Xingyong; Li, Lan; Yu, Chaohui
BackgroundPrevious studies reported that Epstein-Barr virus (EBV) may play a causal role in the pathogenesis of gastric remnant carcinoma (GRC). However, there was still some controversy.MethodsArticles published until July 15, 2020, in PubMed, MEDLINE, Embase and CNKI databases were selected. According to the inclusion criteria, corresponding data of included articles were abstracted and used for statistical analysis.ResultsThirteen papers were finally enrolled, nine of which showed the result that the risk of EBV infection rate in the GRC was higher than conventional gastric carcinoma (OR=5.22, 95% CI 3.89-7.00). In addition, we found that EBV associated GRC (EBVaGRC) had higher rate of Billroth-II (OR=3.80, 95% CI 1.90-7.57), carcinoma in anastomotic site (OR=2.41, 95% CI 1.27-4.56) and diffuse type (Lauren classification) (OR=1.97, 95% CI 1.04-3.73),while sex, initial diagnosis and lymphocytic infiltration were calculated no statistical difference. By genetic polymorphism analysis, "V-val" subtype of EBNA1 (OR=21.84, 95% CI 11.92-31.76) and "C" subtype of BamHI-W1/I1 (OR=7.07, 95% CI 1.47-34.03) were observed to be highly expressed in EBVaGRC.ConclusionEBV infection rate in the GRC was higher. Further analysis showed that Billroth-II, carcinoma in anastomotic site and diffuse type (Lauren classification) were associated to EBVaGRC. Through analysis of EBV genome polymorphisms, we thought that "V-val" subtype of EBNA1 and "C" subtype of BamHI-W1/I1 may become predictor of EBVaGRC.