To synthesize current evidence on predictive biomarkers and emerging therapeutic targets in poorly cohesive gastric cancer (PCGC), and to examine their relevance to PCGC while identifying gaps in histology-specific evidence.
Approach:
Biological Characteristics: Examines the distinct biological features of PCGC, including diffuse growth and intratumoral heterogeneity.
Diagnostic Challenges: Discusses the difficulties in early detection and diagnosis due to the subtle and heterogeneous characteristics of poorly cohesive tumors.
Therapeutic Options: Reviews novel targeted agents and treatment platforms, including HER2, PD-L1, CLDN18.2, FGFR2b, and TROP2.
Technological Advances: Highlights developments in digital pathology, artificial intelligence, and multi-omics for enhancing diagnostic reproducibility and personalized treatment.
Key Findings:
PCGC is associated with a poorer prognosis compared to other gastric cancer subtypes.
Molecular biomarkers such as HER2, PD-L1, and CLDN18.2 are critical for guiding therapeutic strategies.
Current evidence for biomarker-driven therapies primarily derives from unselected gastric adenocarcinoma cohorts, limiting applicability to PCGC.
Limitations:
Existing studies often do not stratify by histological subtype, limiting the understanding of targeted therapies in PCGC.
The clinical effects of emerging treatments in poorly cohesive tumors remain incompletely defined.
