Gastric Cancer Pathophysiology and Therapeutics
Summary
Gastric cancer arises through a multistep cascade beginning with chronic mucosal injury, often driven by Helicobacter pylori infection, dietary factors and genetic predisposition. Progressive alterations in gastric epithelial cells foster the emergence of metaplasia, dysplasia and ultimately invasive carcinoma. Key molecular drivers include aberrant activation of signalling pathways such as Wnt/β-catenin, MAPK and NF-κB, together with promotion of epithelial–mesenchymal transition, which confers migratory and invasive properties. Tumour progression is shaped by a complex interplay between malignant cells and the surrounding stroma, comprising immune cells, fibroblasts and endothelial elements. This tumour microenvironment mediates angiogenesis, immune evasion and drug resistance. Therapeutic strategies have evolved from surgery, chemotherapy and radiotherapy towards targeted approaches that inhibit oncogenic kinases, block angiogenic factors and harness the immune system through checkpoint inhibition. Biomarker-driven trials centred on molecular subtypes seek to personalise therapy, while advances in endoscopic resection techniques and minimally invasive surgery have improved outcomes in early-stage disease. Ongoing efforts focus on novel small molecules, antibody–drug conjugates and combination regimens designed to overcome resistance mechanisms and reduce recurrence.
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Gastric Cancer Pathophysiology and Therapeutics publication trend
The graph below shows the total number of articles in gastric cancer pathophysiology and therapeutics across all publications each year (not limited to Nature Index journals).
Technical terms
Epithelial–mesenchymal transition (EMT): A biological programme by which epithelial cells acquire mesenchymal traits, enhancing motility and invasiveness in tumour progression.
Tumour microenvironment (TME): The local cellular milieu surrounding tumour cells, including immune cells, fibroblasts, endothelial cells and extracellular matrix, which influences cancer growth and therapy response.
Intratumoural heterogeneity: Cellular and molecular diversity within a single tumour, arising from genetic, epigenetic and microenvironmental variations.
Metaplasia: A reversible change in which one differentiated cell type is replaced by another, often as an adaptive response that may predispose to malignant transformation.
Endoscopic mucosal resection (EMR): A minimally invasive procedure that removes superficial gastric lesions for both diagnosis and curative intent in early cancer.
References
- Gastric Cancer: Advances in Carcinogenesis Research and New Therapeutic Strategies. International Journal of Molecular Sciences (2021).
- Early Gastric Cancer: Update on Prevention, Diagnosis and Treatment. International Journal of Environmental Research and Public Health (2023).
- Single-cell analysis of gastric pre-cancerous and cancer lesions reveals cell lineage diversity and intratumoral heterogeneity. npj Precision Oncology (2022).
- Gastric Cancer Epidemiology: Current Trend and Future Direction. Hygiene (2023).
- Immunological Aspects of the Tumor Microenvironment and Epithelial-Mesenchymal Transition in Gastric Carcinogenesis. International Journal of Molecular Sciences (2020).
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