Genetic clues can separate stomach cancer into two distinct types

In collaboration with the Press Association

Research from Singapore identifying genetic differences that distinguish two distinct types of stomach cancer could give clues for better ways to treat the disease.

Currently experts use a microscopic test to assess how tumour cells are arranged, describing them as either "intestinal" or "diffuse". But the Lauren classification, named after the doctor who first recognised the differences, is not precise enough to help doctors predict how patients will respond to different treatments.

The latest research from Duke-National University of Singapore Graduate Medical School looked at the genomes of stomach cancer cells grown in the lab to see if there were significant differences between samples.

Where the Lauren classification was clear, the analysis backed up the findings. But importantly, in cases where the cell grouping could not be distinguished with the traditional test, the genetic analysis was able to separate the cancers into two distinct groups.

The researchers also found that the two tumour types responded differently to chemotherapy treatment. The chemotherapy drugs 5-fluorouracil and oxaliplatin were more effective in treating intestinal tumours, while diffuse tumours responded better to the drug cisplatin.

The findings, published in the journal Gastroenterology, could in the future help doctors to select the most effective treatment for each patient.

Senior author of the study, Professor Patrick Tan, said: "Our study is the first to show that a proposed molecular classification of gastric cancer can identify genomic subtypes that respond differently to therapies, which is crucial in efforts to customize treatments for patients."

Nell Barrie, senior science information officer at Cancer Research UK, said "Doctors are moving away from a 'one size fits all' approach to treating each type of cancer, and this study suggests that it could be possible to tailor treatment for people with stomach cancer. It's only by understanding the biology of the disease that we can make sure each patient will get the treatment that works best for them in the future."

Copyright Press Association 2011

References

  • Tan, I. B. et al. Intrinsic subtypes of gastric cancer, based on gene expression pattern, predict survival and respond differently to chemotherapy. Gastroenterology DOI:10.1053/j.gastro.2011.04.042