{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T06:50:59Z","timestamp":1772866259230,"version":"3.50.1"},"reference-count":50,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"\n PURPOSE<\/jats:title>\n This study aimed to characterize the genomic landscape of Korean gastric cancer and evaluate associations among oncogenic alterations, established biomarkers, demographics, and treatment outcomes.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A total of 1,283 patients with gastric cancer who underwent tumor-only targeted sequencing as part of practice and received palliative treatment between January 2017 and August 2025 at the Samsung Medical Center were included.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Among 1,283 patients (median [IQR] age, 61 [52-68] years; 827 males [64.46%]),\n TP53<\/jats:italic>\n (51.91%),\n ARID1A<\/jats:italic>\n (19.02%),\n ERBB2<\/jats:italic>\n (12%),\n KRAS<\/jats:italic>\n (10.29%), and\n PIK3CA<\/jats:italic>\n (9.12%) were the most frequently altered genes. Epstein-Barr virus\u2013positive tumors exhibited enrichment of\n BCOR<\/jats:italic>\n ,\n PIK3CA<\/jats:italic>\n , and\n ARID1A<\/jats:italic>\n alterations and reduced\n TP53<\/jats:italic>\n mutations (false discovery rate [FDR] adjusted\n P<\/jats:italic>\n < .01). Human epidermal growth factor receptor 2\u2013positive tumors were characterized by coamplification of\n ERBB2<\/jats:italic>\n ,\n CCNE1<\/jats:italic>\n , and\n MYC<\/jats:italic>\n (FDR adjusted\n P<\/jats:italic>\n < .001), whereas PD-L1 positivity was associated with\n KRAS<\/jats:italic>\n and\n CDKN2A<\/jats:italic>\n alterations (FDR-adjusted\n P<\/jats:italic>\n < .05). Among patients treated with first-line nivolumab plus chemotherapy (n = 269), those with high tumor mutational burden (TMB; \u226510 mutations per megabase) had improved overall survival (\n v<\/jats:italic>\n the low TMB subgroup; hazard ratio [HR], 0.48 [95% CI, 0.25 to 0.93];\n P<\/jats:italic>\n = .03), particularly when combined with PD-L1 positivity (\n v<\/jats:italic>\n all other biomarker-defined subgroups; HR, 0.33 [95% CI, 0.14 to 0.76];\n P<\/jats:italic>\n = .006). Moreover, as TMB levels increased, patients derived greater survival benefit from nivolumab plus chemotherapy versus chemotherapy alone, even among those with microsatellite-stable tumors. Across treatment regimens,\n FGFR2<\/jats:italic>\n and\n MET<\/jats:italic>\n alterations were linked to poorer outcomes, whereas\n PIK3CA<\/jats:italic>\n mutations were observed in patients with longer overall survival after first-line chemotherapy.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Our findings provide a comprehensive genomic landscape of Korean gastric cancer and underscore the clinical relevance of integrating genomic and established biomarkers to advance precision oncology.<\/jats:p>\n <\/jats:sec>","DOI":"10.1200\/po-25-01090","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T20:59:11Z","timestamp":1771534751000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Genomic Landscape of Korean Gastric Cancer: Integrating Biomarker Associations and Clinical Outcomes in Metastatic Gastric Cancer"],"prefix":"10.1200","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8749-7050","authenticated-orcid":true,"given":"Seong-Keun","family":"Yoo","sequence":"first","affiliation":[{"name":"Samsung Precision Genome Medicine Institute, Samsung Medical Center, Seoul, Republic of Korea"},{"name":"Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soomin","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinha","family":"Hwang","sequence":"additional","affiliation":[{"name":"Samsung Precision Genome Medicine Institute, Samsung Medical Center, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8087-7340","authenticated-orcid":true,"given":"Jongwu","family":"Kim","sequence":"additional","affiliation":[{"name":"Samsung Precision Genome Medicine Institute, Samsung Medical Center, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2719-2987","authenticated-orcid":true,"given":"Yunjin","family":"Go","sequence":"additional","affiliation":[{"name":"Samsung Precision Genome Medicine Institute, Samsung Medical Center, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1833-6576","authenticated-orcid":true,"given":"Minsuk","family":"Kwon","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Hee","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7335-1846","authenticated-orcid":true,"given":"Seung Tae","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1162-9205","authenticated-orcid":true,"given":"Kyoung-Mee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 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