Gastric cancer is the third most common cause of cancer related death worldwide. Every year around 725 000 people die due to gastric cancer. Due to a lack of early symptoms and no effective screening programs most gastric and esophagogastric junction cancers are diagnosed in a locally advanced or metastatic stage in Western countries. Even in localized stages long term survival is below 50 %.
Perioperative systemic treatment has significantly changed the management of locally advanced tumors resulting in a survival benefit of about 15% in comparison to surgery alone. However a relevant part of patients does still not show a major response to perioperative treatment and is exposed to a potentially ineffective and toxic treatment.
This pilot trial examines the feasibility of a molecular classification from the initial biopsy. In parallel the predictive value of a patient-derived organoid model with respect to treatment efficacy is explored. In patients not responding to neoadjuvant treatment (showing no or only a minor histological response), further individual treatment recommendations based on molecular alterations will be given.
We believe that molecular stratification in combination with in vitro response testing in organoids has the potential to aid therapy stratifications and thereby improve the outcome of gastric cancer patients.
Scientific Goals
- Classification of tumors to molecularly defined subtypes and correlation with histological response to neoadjuvant systemic treatment
- Analysis of the predictive value of the gastric cancer organoid model to predict patient’s histological Response
- Understand mechanisms of resistance against perioperative systemic treatment
- Develop effective treatment options in non-responders
