Evolution of Biomarkers and Current Diagnostic Testing in Gastric Cancer

Panelists discuss how biomarker discovery has transformed the diagnostic and therapeutic framework for gastric cancer. The conversation highlights that while the earliest breakthrough came with HER2 testing, the field has expanded substantially to encompass a wider range of molecular markers influencing treatment selection and prognosis. Comprehensive genomic profiling now provides essential information on tumor biology, revealing both targetable alterations and predictive markers for treatment response. These advances underscore the increasing integration of precision medicine principles into gastric cancer management.

The discussion explores current testing guidelines, emphasizing the importance of performing biomarker assessment at diagnosis for patients with locally advanced or metastatic disease. Molecular profiling—including evaluation for HER2, PD-L1, microsatellite instability, and emerging biomarkers such as FGFR2b—is recommended to guide initial therapy and clinical trial eligibility. Panelists note that adherence to these guidelines remains variable, with institutional differences affecting turnaround times and access to molecular testing platforms.

Remaining challenges include inconsistent testing practices, limited tissue availability, and logistical delays in obtaining results. Panelists stress the need for multidisciplinary collaboration and greater standardization to ensure timely biomarker testing, enabling clinicians to make evidence-based treatment decisions from the outset. Broader implementation of next-generation sequencing panels may further streamline detection of relevant genomic alterations.