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Sequencing 295 stomach cancers divided them into four molecular groups, Epstein-Barr virus-positive, microsatellite unstable, genomically stable and chromosomally unstable, each with distinct drivers and potential therapies.
Integrated genomic analysis by The Cancer Genome Atlas of 295 primary gastric adenocarcinomas identifying four subtypes: Epstein-Barr virus-positive (PIK3CA mutations, PD-L1/2 amplification), microsatellite unstable (hypermutation), genomically stable (diffuse histology, RHOA and CLDN18-ARHGAP fusions) and chromosomal instability (TP53 mutation, receptor tyrosine kinase amplifications).
The immunotherapy sensitivity of microsatellite-unstable and Epstein-Barr virus-positive gastric cancer and the claudin 18.2 and HER2 targets map onto these subtypes.