# Comprehensive molecular characterisation of gastric adenocarcinoma (The Cancer Genome Atlas)

Source: https://onco.cc/key-papers/paper-tcga-gastric-nature-2014/  
OnCo record `paper-tcga-gastric-nature-2014` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Summary

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).

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Nature
- Year: 2014
- DOI: 10.1038/nature13480
- Authors: Cancer Genome Atlas Research Network.
- Findings: Four molecular subtypes with distinct genomic features.; Microsatellite-unstable tumours in about 22 percent and Epstein-Barr virus-positive in about 9 percent of the cohort.
- What it means: 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.
- Caveats: Subtypes are not yet used directly to choose treatment beyond microsatellite status and HER2.

## Sources

- Nature 2014: https://doi.org/10.1038/nature13480
- PubMed: https://pubmed.ncbi.nlm.nih.gov/25079317/

## Connected records

- cancers: [Microsatellite-unstable (MSI-high) gastric cancer](https://onco.cc/cancers/gastric-msi-high/)
- journals: [Nature](https://onco.cc/journals/nature/)

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