Gastric Cancer
Labcorp Oncology offers a comprehensive test menu to assist in the diagnosis and management of patients with gastric cancer throughout their continuum of care.
Genetic Risk Assessment
Germline Testing
VistaSeq® Hereditary Cancer Panels
Provides an assessment of genetic mutations known to be associated with hereditary cancer syndromes.
Germline Testing
Lynch Syndrome Germline Testing
Full gene sequencing and deletion/duplication analysis to confirm a clinical diagnosis of Lynch syndrome. Gastric cancer risk in Lynch syndrome is estimated to be between 5 and 13%.1
Diagnostic
Diagnostic
Complex Tumor Analysis by IHC
Our extensive antibody library and team of experienced pathologists can provide a differential diagnostic analysis in even the most difficult cases.
Prognostic
Prognostic
MSI by PCR or Mismatch repair (MMR) panel by IHC
Universal testing for MSI by PCR or MMR by IHC should be performed for all newly diagnosed patients with gastric cancer. Up to 20% gastric cancers have been reported to have microsatellite instability.2
Learn more about MSI by PCR or Mismatch repair (MMR) panel by IHC
Prognostic
HER2 by IHC and FISH
Overexpression of the HER2 protein or amplification of the ERBB2 gene has been shown to play a role in the development of gastric cancer. HER2 overexpression occurs in 10-20% of gastric cancers.3
Prognostic
BRAF Gene Mutation Analysis
This test will detect all V600 mutations of the BRAF oncogene frequently found in human cancers, including gastric cancer, allowing the determination of drug response, aiding the diagnosis, and providing prognosis information.
Biomarkers for Therapeutic Selection
Biomarkers and tests for clinical management and treatment decision-making
| Test | Detects | Therapy |
|---|---|---|
| BRAF gene mutation analysis | Mutations in the BRAF gene | Dabrafenib4 and trametinib5 |
| Claudin 18 by IHC | Claudin 18 protein expression | zolbetuximab6,7 |
| HER2 by IHC and HER2 by FISH | HER2 overexpression or amplification | Trastuzumab8 , fam-trastuzumab - deruxtecan-nxki9 |
| Labcorp® Plasma Focus™ | 33 actionable or clinically relevant genes for somatic single nucleotide variants (SNVs) and insertions/deletions (indels) | Targeted therapies |
| Microsatellite Instability (MSI) by PCR or Mismatch Repair (MMR) Proteins by IHC | Microsatellite instability (MSI)/mismatch repair (MMR) deficiency | Pembrolizumab10, nivolumab11 and ipilimumab12 dostarlimab-gxly13 |
| OmniSeq® INSIGHT, solid tumor NGS panel (DNA and RNA) | Includes DNA and RNA sequencing (523 genes), MSI, TMB*, fusion analysis including NTRK and RET, PD-L1 IHC and immune gene profiling | Targeted therapies and immunotherapies |
| PD-L1 (22C3) by IHC | Protein expression | Pembrolizumab10 |
| RET by FISH | RET rearrangements (translocations) | Selpercatinib14 |
*TMB - tumor mutational burden
Monitoring
Monitoring
Cancer Antigen 19-9
For the quantitative determination of CA 19-9 tumor-associated antigen in serum or plasma of patients with gastric cancer to monitor disease progress.13
References
Caspers, I. A. et al, Gastric and duodenal cancer in individuals with Lynch syndrome: a nationwide cohort study, eClinicalMedicine 2024;69: 102494.
Ratti M, Lampis A, Hahne JC, et al. Microsatellite instability in gastric cancer: molecular bases, clinical perspectives, and new treatment approaches. Cell Mol Life Sci. 2018 Nov;75(22):4151-4162.
Pous A, Notario L, Hierro C, Layos L, Bugés C. HER2-Positive Gastric Cancer: The Role of Immunotherapy and Novel Therapeutic Strategies. Int J Mol Sci. 2023 Jul 13;24(14):11403.
TAFINLAR® (Drabrafinib)[package insert] East Hanover, NJ: Novartis Pharmaceuticals Corporation 2024.
MEKINIST® (trametinib) [package insert] East Hanover, NJ: Novartis Pharmaceuticals Corporation 2024.
Shitara K, Lordick F, Bang YJ, et al. Lancet 2023 Apr 14:S0140-6736(23)00620-7.
Xu RH, Shitara K, Ajani JA, et al. #405736. Presented at: March American Society of Clinical Oncology Plenary Series; March 22, 2023.
HERCEPTIN® (trastuzumab) [package insert]. South San Francisco, CA: Genentech, Inc.; 2010.
ENHERTU® (fam-trastuzumab deruxtecan-nxki). [package insert]. Daiichi Sankyo, Inc., Basking Ridge, NJ, 2019.
KEYTRUDA® (pembrolizumab) [package insert]. Whitehouse Station, NJ: Merck &Co., Inc.; 2021.
JEMPERLI (dostarlimab-gxly) [package insert]. Philadelphia, PA: GlaxoSmithKline LLC; 2023.
Herlyn M, et al. Monoclonal antibody detection of a circulating tumor-associated antigen. Presence of antigen in sera of patients with colorectal, gastric, and pancreatic carcinoma. J Clin Immunol. 1982 Apr; 2(2):135-140.
OPDIVO® (nivolumab) [package insert]. Princeton, NJ 08543: Bristol-Myers Squibb Company, 2024
YERVOY® (ipilimumab) [package insert]. Princeton, NJ 08543: Bristol-Myers Squibb Company, 2023
RETEVMO™ (selpercatinib) [package insert]. Indianapolis, IN: Lilly USA, LLC; 2021.