New Challenges for Gastric Cancer—Gut Microbiota, Post-eradication and Chemotherapy

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 2185

Special Issue Editors


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Guest Editor
Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu 879-5593, Japan
Interests: Helicobacter pylori; gastric cancer; cell cycle; immunohistochemistry; biliary duct cancer

E-Mail Website
Guest Editor
Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu 879-5593, Japan
Interests: Helicobacter pylori; gastric cancer; endoscopic procedure; capsule endoscopy; image enhancement endoscopy; gastroesophageal reflux disease; anisakidosis
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Special Issue Information

Dear Colleagues,

Although gastric cancer is declining due to the establishment of Helicobacter pylori (H. pylori) eradication therapy, there are still many gastric cancer deaths worldwide. New findings are still being found to overcome the disadvantages of gastric cancer in patients. Recently, it has been reported that H. pylori-infected patients and patients with intestinal metaplasia have a high diversity of intestinal microbiota, and there is an association with gastric cancer in the stomach microbiota. In addition, gastric cancer after H. pylori eradication has different characteristics from conventional H. pylori-associated gastric cancer, so we must continue to acquire new knowledge about this cancer type. In terms of treatment, minimally invasive therapy for early-stage gastric cancer has become widespread, and recently, chemotherapy, including immune checkpoint inhibitors, has been advancing at an rapid rate.

In this Special Issue, we will collect the latest findings in this new phase of gastric cancer.

Dr. Kazunari Murakami
Dr. Kazuhiro Mizukami
Guest Editors

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Keywords

  • gastric cancer
  • microbiota
  • Helicobacter pylori
  • after Helicobacter pylori eradication therapy
  • chemotherapy
  • immune checkpoint inhibitor

Published Papers (3 papers)

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Research

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12 pages, 2265 KiB  
Article
Deep Learning Histology for Prediction of Lymph Node Metastases and Tumor Regression after Neoadjuvant FLOT Therapy of Gastroesophageal Adenocarcinoma
by Jin-On Jung, Juan I. Pisula, Xenia Beyerlein, Leandra Lukomski, Karl Knipper, Aram P. Abu Hejleh, Hans F. Fuchs, Yuri Tolkach, Seung-Hun Chon, Henrik Nienhüser, Markus W. Büchler, Christiane J. Bruns, Alexander Quaas, Katarzyna Bozek, Felix Popp and Thomas Schmidt
Cancers 2024, 16(13), 2445; https://doi.org/10.3390/cancers16132445 - 3 Jul 2024
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Abstract
Background: The aim of this study was to establish a deep learning prediction model for neoadjuvant FLOT chemotherapy response. The neural network utilized clinical data and visual information from whole-slide images (WSIs) of therapy-naïve gastroesophageal cancer biopsies. Methods: This study included 78 patients [...] Read more.
Background: The aim of this study was to establish a deep learning prediction model for neoadjuvant FLOT chemotherapy response. The neural network utilized clinical data and visual information from whole-slide images (WSIs) of therapy-naïve gastroesophageal cancer biopsies. Methods: This study included 78 patients from the University Hospital of Cologne and 59 patients from the University Hospital of Heidelberg used as external validation. Results: After surgical resection, 33 patients from Cologne (42.3%) were ypN0 and 45 patients (57.7%) were ypN+, while 23 patients from Heidelberg (39.0%) were ypN0 and 36 patients (61.0%) were ypN+ (p = 0.695). The neural network had an accuracy of 92.1% to predict lymph node metastasis and the area under the curve (AUC) was 0.726. A total of 43 patients from Cologne (55.1%) had less than 50% residual vital tumor (RVT) compared to 34 patients from Heidelberg (57.6%, p = 0.955). The model was able to predict tumor regression with an error of ±14.1% and an AUC of 0.648. Conclusions: This study demonstrates that visual features extracted by deep learning from therapy-naïve biopsies of gastroesophageal adenocarcinomas correlate with positive lymph nodes and tumor regression. The results will be confirmed in prospective studies to achieve early allocation of patients to the most promising treatment. Full article
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15 pages, 2120 KiB  
Article
CA125 Kinetics as a Potential Biomarker for Peritoneal Metastasis Progression following Taxane-Plus-Ramucirumab Administration in Patients with Advanced Gastric Cancer
by Akira Ueda, Satoshi Yuki, Takayuki Ando, Ayumu Hosokawa, Naokatsu Nakada, Yosuke Kito, Iori Motoo, Ken Ito, Miho Sakumura, Yurika Nakayama, Yuko Ueda, Shinya Kajiura, Koji Nakashima, Kazuaki Harada, Yasuyuki Kawamoto, Yoshito Komatsu and Ichiro Yasuda
Cancers 2024, 16(5), 871; https://doi.org/10.3390/cancers16050871 - 22 Feb 2024
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Abstract
Currently, no established marker exists for predicting peritoneal metastasis progression during chemotherapy, although they are major interruptive factors in sequential chemotherapy in patients with advanced gastric cancer (AGC). This multicenter retrospective study was conducted from June 2015 to July 2019, analyzing 73 patients [...] Read more.
Currently, no established marker exists for predicting peritoneal metastasis progression during chemotherapy, although they are major interruptive factors in sequential chemotherapy in patients with advanced gastric cancer (AGC). This multicenter retrospective study was conducted from June 2015 to July 2019, analyzing 73 patients with AGC who underwent taxane-plus-ramucirumab (TAX/RAM) therapy and had their serum carbohydrate antigen 125 (CA125) concentrations measured. Of 31 patients with elevated CA125 levels above a cutoff of 35 U/mL, 25 (80.6%) had peritoneal metastasis. The CA125 concentrations before TAX/RAM treatment were associated with ascites burden. The overall survival was significantly shorter in the CA125-elevated group. CA125 kinetics, measured at a median of 28 days after chemotherapy, were associated with the ascites response (complete or partial response: −1.86%/day; stable disease: 0.28%/day; progressive disease: 2.33%/day). Progression-free survival in the CA125-increased group, defined by an increase of 0.0067%/day using receiver operating characteristic curve analysis, was significantly poorer among patients with peritoneal metastases. In conclusion, this study highlights that CA125 kinetics can serve as an early predictor for the progression of peritoneal metastasis during TAX/RAM treatment. Full article
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Review

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21 pages, 846 KiB  
Review
Emerging Therapeutic Targets and Future Directions in Advanced Gastric Cancer: A Comprehensive Review
by Margherita Ratti, Elena Orlandi, Ilaria Toscani, Stefano Vecchia, Elisa Anselmi, Jens Claus Hahne, Michele Ghidini and Chiara Citterio
Cancers 2024, 16(15), 2692; https://doi.org/10.3390/cancers16152692 (registering DOI) - 29 Jul 2024
Abstract
Metastatic gastric cancer (GC) still represents a critical clinical challenge, with limited treatment options and a poor prognosis. Most patients are diagnosed at advanced stages, limiting the chances of surgery and cure. The identification of molecular targets and the possibility of combining immune [...] Read more.
Metastatic gastric cancer (GC) still represents a critical clinical challenge, with limited treatment options and a poor prognosis. Most patients are diagnosed at advanced stages, limiting the chances of surgery and cure. The identification of molecular targets and the possibility of combining immune checkpoint inhibitors with chemotherapy have recently reshaped the therapeutic landscape of metastatic gastric cancer. The new classification of gastric cancer, mainly based on immunologic and molecular criteria such as programmed cell death 1 (PD-1), microsatellite instability (MSI), and human epidermal growth factor receptor 2 (HER2), has made it possible to identify and differentiate patients who may benefit from immunotherapy, targeted therapy, or chemotherapy alone. All relevant and available molecular and immunological targets in clinical practice for the systemic treatment of this disease are presented. Particular attention is given to possible future approaches, including circulating tumor DNA (ctDNA) for therapeutic monitoring, new targeting agents against molecular pathways such as fibroblast growth factor receptor (FGFR) and MET, chimeric antigen receptor (CAR)-T cells, and cancer vaccines. This review aims to provide a comprehensive understanding of current targets in advanced gastric cancer and to offer valuable insights into future directions of research and clinical practice in this challenging disease. Full article
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