Approaches and genetic determinants in predicting response to neoadjuvant chemotherapy in locally advanced gastric cancer

// Jichun Zhou 1,2 , Jianguo Shen 1,2 , Benjamin J. Seifer 3 , Shaojie Jiang 4 , Ji Wang 1,2 , Hanchu Xiong 1,2 , Lingmin Xie 1,2 , Linbo Wang 1,2 and Xinbing Sui 2,5 1 Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, China 2 Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, China 3 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA 4 Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, China 5 Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, China Correspondence to: Linbo Wang, email: // Xinbing Sui, email: // Keywords : neoadjuvant chemotherapy, gastric cancer, predictive biomarker, histopathological response, chemosensitivity Received : December 13, 2015 Accepted : October 18, 2016 Published : October 27, 2016 Abstract Gastric cancer remains a major health burden worldwide. There is near-universal agreement that neoadjuvant chemotherapy (NAC) is a preferred management for locally advanced gastric cancer (LAGC). However, the optimal approach for an individual patient is still not clear and remains controversial, which could be at least partly explained by the lack of predictive tools. The ability to predict chemosensitivity from NAC in routine clinical practice is difficult and is an area of intense investigation, especially in the Precision-Medicine Era. Available consistent evidence suggests that a favorable tumor histopathological response to NAC may be a useful positive prognostic marker in gastric cancer. Hence, it is reasonable to speculate that making the histopathological response from NAC predictable will dramatically facility the NAC and improve patients’ outcome. This review provides an overview on the current status of predictive biomarkers for histopathological response from NAC in LAGC, including clinicopathological variables, imaging and molecular testing. Furthermore, limitations and future perspectives are also discussed.