Onkologie. 2024:18(4):254-258 | DOI: 10.36290/xon.2024.052

New targets in gastric cancer

Marián Liberko1, 2, Renata Soumarová1, 2
1 Onkologická klinika, 3. LF UK a FNKV, Praha
2 3. lékařská fakulta Univerzity Karlovy, Praha

Gastric cancer is a heterogeneous disease, both in terms of the frequency of occurrence in individual regions and the frequency of specific molecular alterations that are potentially targetable. In addition to the standard accepted, classical predictive and prognostic biomarkers (Her2, MMR or MSI, PD-L1 CPS) that need to be known prior to therapy, new ones are emerging that have the potential to significantly impact our treatment algorithms and ultimately patient prognosis. The aim of this article is to provide an overview of new potential therapeutic targets (CLDN 18.2, FGFR2b) in the treatment of this disease that, based on the positive results of recent studies, may be introduced into routine clinical practice in the near future.

Keywords: metastatic gastric cancer, FGFR2b, CLDN 18.2, immunotherapy.

Accepted: October 1, 2024; Published: October 7, 2024  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Liberko M, Soumarová R. New targets in gastric cancer. Onkologie. 2024;18(4):254-258. doi: 10.36290/xon.2024.052.
Download citation

References

  1. Ferlay J, Ervik M, Colombet M, et al. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/today. Published 2022. Accessed May 19, 2024.
  2. GBD 2017 Stomach Cancer Collaborators. The global, regional, and national burden of stomach cancer in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease study 2017. Lancet Gastroenterol Hepatol. 2020;5(1):42-54. doi: 10.1016/S2468-1253(19)30328-0. Epub 2019 Oct 21. Erratum in: Lancet Gastroenterol Hepatol. 2020;5(3):e2. PMID: 31648970; PMCID: PMC7033564. Go to original source... Go to PubMed...
  3. Colquhoun A, Arnold M, Ferlay J, et al. Global patterns of cardia and non-cardia gastric cancer incidence in 2012. Gut. 2015;64(12):1881-1888. doi: 10.1136/gutjnl-2014-308915. Epub 2015 Mar 6. PMID: 25748648. Go to original source... Go to PubMed...
  4. Lordick F, Carneiro F, Cascinu S, et al. Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022;33(10):1005-1020. doi: 10.1016/j.annonc.2022.07.004. Epub 2022 Jul 29. PMID: 35914639. Go to original source... Go to PubMed...
  5. Cancer Genome Atlas Research Network. Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513(7517):202-209. doi: 10.1038/nature13480. Epub 2014 Jul 23. PMID: 25079317; PMCID: PMC4170219. Go to original source... Go to PubMed...
  6. Jung EJ, Jung EJ, Min SY, et al. Fibroblast growth factor receptor 2 gene amplification status and its clinicopathologic significance in gastric carcinoma. Hum Pathol. 2012;43(10):1559-1566. doi: 10.1016/j.humpath.2011.12.002. Epub 2012 Mar 21. PMID: 22440694. Go to original source... Go to PubMed...
  7. Van Cutsem E, Bang YJ, Mansoor W, et al. A randomized, open-label study of the efficacy and safety of AZD4547 monotherapy versus paclitaxel for the treatment of advanced gastric adenocarcinoma with FGFR2 polysomy or gene amplification. Ann Oncol. 2017;28(6):1316-1324. doi: 10.1093/annonc/mdx107. PMID: 29177434. Go to original source... Go to PubMed...
  8. Catenacci DVT, Rasco D, Lee J, et al. Phase I Escalation and Expansion Study of Bemarituzumab (FPA144) in Patients With Advanced Solid Tumors and FGFR2b-Selected Gastroesophageal Adenocarcinoma. J Clin Oncol. 2020;38(21):2418-2426. doi: 10.1200/JCO.19.01834. Epub 2020 Mar 13. PMID: 32167861; PMCID: PMC7367551. Go to original source... Go to PubMed...
  9. Xiang H, Chan AG, Ahene A, et al. Preclinical characterization of bemarituzumab, an anti-FGFR2b antibody for the treatment of cancer. MAbs. 2021;13(1):1981202. doi: 10.1080/19420862.2021.1981202. PMID: 34719330; PMCID: PMC8565817. Go to original source... Go to PubMed...
  10. Wainberg ZA, Enzinger PC, Kang YK, et al. Bemarituzumab in patients with FGFR2b-selected gastric or gastro-oesophageal junction adenocarcinoma (FIGHT): a randomised, double-blind, placebo-controlled, phase 2 study. Lancet Oncol. 2022;23(11):1430-1440. doi: 10.1016/S1470-2045(22)00603-9. Epub 2022 Oct 14. PMID: 36244398. Go to original source... Go to PubMed...
  11. Wainberg Z, Kang Y, Lee K, et al. Bemarituzumab for treatment of previously untreated advanced and/or metastatic gastric and gastroesophageal cancer: Final analysis of a randomized phase 2 trial (FIGHT). Ann Oncol 2023;34(Suppl1):S166. doi:10.1016/j.annonc.2023.04.483. Go to original source...
  12. Smyth EC, Chao J, Muro K, et al. Trial in progress: Phase 3 study of bemarituzumab + mFOLFOX6 versus placebo + mFOLFOX6 in previously untreated advanced gastric or gastroesophageal junction (GEJ) cancer with FGFR2b overexpression (FORTITUDE-101). JCO. 2022;40:TPS4164-TPS4164. doi: 10.1200/JCO.2022.40.16_suppl.TPS4164. Go to original source...
  13. Wainberg ZA, Van Cutsem E, Moehler MH, et al. Trial in progress: Phase 1b/3 study of bemarituzumab + mFOLFOX6 + nivolumab versus mFOLFOX6 + nivolumab in previously untreated advanced gastric and gastroesophageal junction (GEJ) cancer with FGFR2b overexpression (FORTITUDE-102). JCO. 2022;40:TPS4165-TPS4165. doi:10.1200/JCO.2022.40.16_suppl.TPS4165. Go to original source...
  14. Niimi T, Nagashima K, Ward JM, et al. claudin-18, a novel downstream target gene for the T/EBP/NKX2.1 homeodomain transcription factor, encodes lung- and stomach-specific isoforms through alternative splicing. Mol Cell Biol. 2001;21(21):7380-7390. doi: 10.1128/MCB.21.21.7380-7390.2001. PMID: 11585919; PMCID: PMC99911. Go to original source... Go to PubMed...
  15. Sahin U, Koslowski M, Dhaene K, et al. Claudin-18 splice variant 2 is a pan-cancer target suitable for therapeutic antibody development. Clin Cancer Res. 2008;14(23):7624-7634. doi: 10.1158/1078-0432.CCR-08-1547. PMID: 19047087. Go to original source... Go to PubMed...
  16. Türeci O, Sahin U, Schulze-Bergkamen H, et al. A multicentre, phase IIa study of zolbetuximab as a single agent in patients with recurrent or refractory advanced adenocarcinoma of the stomach or lower oesophagus: the MONO study. Ann Oncol. 2019;30(9):1487-1495. doi: 10.1093/annonc/mdz199. PMID: 31240302; PMCID: PMC6771222. Go to original source... Go to PubMed...
  17. Sahin U, Türeci Ö, Manikhas G, et al. FAST: a randomised phase II study of zolbetuximab (IMAB362) plus EOX versus EOX alone for first-line treatment of advanced CLDN18.2-positive gastric and gastro-oesophageal adenocarcinoma. Ann Oncol. 2021;32(5):609-619. doi: 10.1016/j.annonc.2021.02.005. Epub 2021 Feb 19. PMID: 33610734. Go to original source... Go to PubMed...
  18. Shitara K, Lordick F, Bang YJ, et al. Zolbetuximab plus mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative, untreated, locally advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (SPOTLIGHT): a multicentre, randomised, double-blind, phase 3 trial. Lancet. 2023;401(10389):1655-1668. doi: 10.1016/S0140-6736(23)00620-7. Epub 2023 Apr 15. Erratum in: Lancet. 2023;402(10398):290. doi: 10.1016/S0140-6736(23)01481-2. Erratum in: Lancet. 2024;403(10421):30. doi: 10.1016/S0140-6736(23)02762-9. PMID: 37068504. Go to original source... Go to PubMed...
  19. Shah MA, Shitara K, Ajani JA, et al. Zolbetuximab plus CAPOX in CLDN18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 GLOW trial. Nat Med. 2023;29(8):2133-2141. doi: 10.1038/s41591-023-02465-7. Epub 2023 Jul 31. PMID: 37524953; PMCID: PMC10427418. Go to original source... Go to PubMed...
  20. Shitara K, Van Cutsem E, Bang YJ, et al. Efficacy and Safety of Pembrolizumab or Pembrolizumab Plus Chemotherapy vs Chemotherapy Alone for Patients With First-line, Advanced Gastric Cancer: The KEYNOTE-062 Phase 3 Randomized Clinical Trial. JAMA Oncol. 2020;6(10):1571-1580. doi: 10.1001/jamaoncol.2020.3370. PMID: 32880601; PMCID: PMC7489405. Go to original source... Go to PubMed...
  21. Wainberg ZA, Shitara K, Van Cutsem E, et al. Pembrolizumab with or without chemotherapy versus chemotherapy alone for patients with PD-L1-positive advanced gastric or gastroesophageal junction adenocarcinoma: Update from the phase 3 KEYNOTE-062 trial. JCO. 2022;40:243-243. doi: 10.1200/JCO.2022.40.4_suppl.243. Go to original source...
  22. Janjigian YY, Ajani JA, Moehler M, et al. First-Line Nivolumab Plus Chemotherapy for Advanced Gastric, Gastroesophageal Junction, and Esophageal Adenocarcinoma: 3-Year Follow-Up of the Phase III CheckMate 649 Trial. J Clin Oncol. 2024 Feb 21:JCO2301601. doi: 10.1200/JCO.23.01601. Epub ahead of print. PMID: 38382001. Go to original source... Go to PubMed...
  23. Shitara K, Ajani JA, Moehler M, et al. Nivolumab plus chemotherapy or ipilimumab in gastro-oesophageal cancer. Nature. 2022;603(7903):942-948. doi: 10.1038/s41586-022-04508-4. Epub 2022 Mar 23. PMID: 35322232; PMCID: PMC8967713. Go to original source... Go to PubMed...
  24. Shitara K, Özgüroğlu M, Bang YJ, et al. Pembrolizumab versus paclitaxel for previously treated, advanced gastric or gastro-oesophageal junction cancer (KEYNOTE-061): a randomised, open-label, controlled, phase 3 trial. Lancet. 2018;392(10142):123-133. doi: 10.1016/S0140-6736(18)31257-1. Epub 2018 Jun 4. PMID: 29880231. Go to original source... Go to PubMed...
  25. Chao J, Fuchs CS, Shitara K, et al. Assessment of Pembrolizumab Therapy for the Treatment of Microsatellite Instability-High Gastric or Gastroesophageal Junction Cancer Among Patients in the KEYNOTE-059, KEYNOTE-061, and KEYNOTE-062 Clinical Trials. JAMA Oncol. 2021;7(6):895-902. doi: 10.1001/jamaoncol.2021.0275. PMID: 33792646; PMCID: PMC8017478. Go to original source... Go to PubMed...
  26. Marabelle A, Le DT, Ascierto PA, et al. Efficacy of Pembrolizumab in Patients With Noncolorectal High Microsatellite Instability/Mismatch Repair-Deficient Cancer: Results From the Phase II KEYNOTE-158 Study. J Clin Oncol. 2020;38(1):1-10. doi: 10.1200/JCO.19.02105. Epub 2019 Nov 4. PMID: 31682550; PMCID: PMC8184060. Go to original source... Go to PubMed...
  27. Lordick F, Carneiro F, Cascinu S, et al. Electronic address: clinicalguidelines@esmo.org. Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022;33(10):1005-1020. doi: 10.1016/j.annonc.2022.07.004. Epub 2022 Jul 29. PMID: 35914639. Go to original source... Go to PubMed...
  28. Muro K, Kawakami H, Kadowaki S. NO LIMIT study. Ann Oncol. 2023;43(Supplement 2):S852-S853. https://doi.org/10.1016/j.annonc.2023.09.1426. Go to original source...




Oncology

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.