AsianScientist (Jun. 13, 2025) – Gastric cancer is a major global health concern, ranking as the fifth most common cancer and the third leading cause of cancer-related deaths worldwide, with close to 770,000 deaths each year. In Singapore alone, gastric cancer is among the top 10 causes of cancer-related deaths, taking about 300 lives annually.
But scientists in Singapore have now made a significant discovery to tackle the disease.
A team of researchers from the Singapore Gastric Cancer Consortium has created a detailed “atlas” of stomach tumours, using advanced mapping technologies, revealing hidden patterns in how cancer cells behave, evolve and interact with their environment.
The study, published in Cancer Discovery, has the potential to transform how stomach cancer is diagnosed and treated — by tailoring therapies to the unique makeup of a patient’s tumour. These insights could lead to more precise, targeted treatments that improve survival rates and reduce side effects.
Led by doctors and scientists from Duke-NUS Medical School, the National University Cancer Institute, Singapore (NCIS), and the NUS Yong Loo Lin School of Medicine, the team spent three years, from January 2022 to December 2024, analysing 226 gastric cancer samples from 121 patients using geospatial and genomic technologies.
“The integration of spatial technologies and genetic engineering tools is like upgrading from an old roadmap to a high-tech GPS for cancer. Now, we can pinpoint exactly where cancer cells are in a tumour, how they behave and what makes them spread or stay put,” said Professor Patrick Tan, a senior author of the study and senior vice-dean for research at Duke-NUS.
Using a technology called spatial transcriptomics, the team collated data from 2,000 microregions of the tumour samples, and analysed 150,000 single cells through single-cell RNA sequencing. Integrating these two approaches allowed the creation of a highly detailed map of gastric cancer tissues. By combining these approaches, they created a high-resolution view of tumour ecosystems, capturing the complexity of how cancer cells interact with nearby non-cancerous cells like immune cells and blood vessels.
One of the most important findings was the discovery of two subgroups of cancer cells within the same tumour. Cells in the core of the tumour had poor oxygen supply and were less likely to spread. Meanwhile, cells at the edges showed signs of being more invasive and more likely to migrate to other parts of the body.
Understanding these differences matters. The researchers found that cells near the tumour edges were surrounded by a unique type of non-cancerous cells that are influenced by a signaling molecule called TGF-β (transforming growth factor-beta). This molecule is known to play a role in cancer growth and the body’s immune response. By targetingTGF-β signaling, future therapies could potentially weaken the tumour’s defences and stop it from spreading.
The team also identified different evolutionary pathways for stomach cancer, each with its own impact on how the disease progresses and how it responds to treatment. These discoveries could help doctors decide which treatment strategy will work best for a particular patient — a step closer to personalised cancer care.
The researchers are now working on identifying even more therapeutic targets for the treatment of gastric cancer, and testing them in pre-clinical models. Their goal is to develop smarter, more effective treatments that can be tailored to each patient’s tumour type.
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Source: Duke-NUS Medical School ; Image: Shutterstock
The study can be found at : Spatially Resolved Tumor Ecosystems and Cell States in Gastric Adenocarcinoma Progression and Evolution
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.
Keywords: gastric cancer, stomach cancer, cancer, tumour
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