Epidemiology and genomics of gastric adenocarcinomas in Brazil

Abstract

Gastric Adenocarcinomas (AdGs) present high mortality rates worldwide. Whereas the pathological aspects of the disease are well defined, the current knowledge status of its genesis and evolution remain to be translated to a better diagnosis or to a more effective management: the most contemporary treatment modalities available were not yet able to modify the natural history of the disease. In this sense, this project aims to contribute significantly with the knowledge of AdGs, with special emphasis in the Brazilian population. The epidemiological aspects of the disease will be revisited and combined with multidisciplinary information related to alternative etiologic agents, molecular alterations found in familial and early onset disease as well as markers of neoadjuvant chemotherapy response. The data produced here will be mined to identify factors related to prognosis and to the diversity of the histopathologic types, aiming better diagnosis and therapeutics. A collaborative network composed of medical centers from São Paulo, Fortaleza and Belém (Southeast, Northeast and North of Brazil) will be established to collect detailed epidemiological data from more than 2000 people. Our cancer center in São Paulo will collect tissues and biological fluids, which will be explored, by modern pathology techniques, metagenomics, exome and transcriptome sequencing. In the search of biomarkers we will also investigate epigenetic and structural genomic analysis, together with the study of extracellular vesicles and circulating tumor cells. All of these experiments will be evaluated in the context of the ethnical admixture, which is a particularly strong aspect of Brazilians. Our final goal is to contribute with a more effective treatment to the patients that suffer from this often lethal disease. (AU)