LEGACy · CeLac and European consortium for a personalized medicine approach to Gastric Cancer

Globally, gastric cancer (GC) is the third leading cause of cancer death in both sexes worldwide (723,000 deaths, 8.8% of the total). The highest estimated mortality rates are in Eastern Asia (24 per 100,000 in men, 9.8 per 100,000 in women), the lowest in Northern America (2.8 and 1.5, respectively). High mortality rates are also present in both sexes in Central and Eastern Europe, and in Central and South America. None strategies have improved prognosis in locally advanced stage III and IV GC. Therefore, an urgent intervention is needed. Epidemiological and molecular features of GCs can vary widely according to their histological type, location and genetic makeup of the tumour. The reasons behind these differences are multiple and complex and may include genetic susceptibility, strains of the bacterium Helicobacter pylori (H. pylori) and dietary factors. In particular, H. pylori infection plays a relevant role in GC incidence. Similarly, about 10% of GC patients are positive for the infection of the Epstein Barr Virus (EBV) . Most studies and current international databases on late-stage/advanced GC are largely based on Asian populations, in sharp contrast tumour biology and genome of EU and CELAC countries is poorly known. From a public health standpoint, prevention can be conducted at three levels: primary, secondary, and for improving outcomes at the advanced stage of disease. In recent years, the arrival of personalized medicine has revolutionized available treatments for cancer patients. The primary aim of LEGACY project is to improve GC outcomes by applying personalized medicine at the three levels of prevention: in EU and CELAC countries participating in this multicentre case-control study based on an “omics integrative epidemiology” conceptual model as a strategy to be extended worldwide.