SINGAPORE: A recent breakthrough in gastric cancer research offers new hope to patients suffering from peritoneal metastasis, a condition associated with advanced stages of the disease.

Gastric cancer remains the fifth most common cancer globally and is the third leading cause of cancer-related deaths, with over a million new cases diagnosed annually. In Singapore, it ranks among the top 10 deadliest cancers, claiming approximately 300 lives each year.

For patients with gastric cancer, the peritoneum—the membrane lining the abdominal cavity—is the most common site for metastasis.

Peritoneal metastasis is notorious for its poor prognosis, with median survival ranging between three to six months and five-year survival rates below five per cent. Treatment options have been severely limited, making the fight against this condition especially challenging.

However, researchers and clinicians from Singapore have made a significant leap in understanding the spread of gastric cancer to the peritoneum.

A landmark study published in ‘Gastroenterology’ reveals critical insights into the molecular mechanisms driving this aggressive cancer’s progression.

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The research was conducted by a collaborative team from the National University Hospital (NUH), the National University Cancer Institute (NCIS), the Yong Loo Lin School of Medicine at the National University of Singapore (NUS Medicine), the National Cancer Centre Singapore (NCCS), and Duke-NUS Medical School.

Using advanced genomic and transcriptomic technologies, the research team analyzed an extensive collection of patient samples. This in-depth analysis has allowed the team to uncover the biological pathways that contribute to the peritoneal spread of gastric cancer.

Associate Professor Raghav Sundar, a Senior Consultant at NCIS and the study’s lead researcher, explained:

“Our research has provided a detailed roadmap of the processes that enable gastric cancer to spread to the peritoneum. This understanding is crucial for developing more targeted and effective treatments.”

In tandem with this breakthrough, a clinical trial called the PIANO trial has demonstrated the potential of an innovative treatment strategy.

Led by Professor Jimmy So, a Senior Consultant at NUH and Professor of Surgery at NUS Medicine, the trial tested the combination of Pressurised Intra-Peritoneal Aerosol Chemotherapy (PIPAC) with immunotherapy.

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The results, published in ‘ESMO Open,’ are described as “incredibly encouraging” and suggest that this combined approach could significantly improve patient outcomes.

Professor So revealed: “The PIANO trial results show that combining targeted therapies with immunotherapy holds great promise for revolutionizing the treatment of gastric cancer peritoneal metastasis.”

This research represents a major step forward in the battle against gastric cancer, offering hope for more personalized treatment strategies.

By identifying predictive biomarkers and therapeutic targets, the study could pave the way for tailored treatment plans based on a patient’s unique cancer profile.