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Modern Pathology, Artificial Intelligence and Personalized Therapy in Gastrointestinal Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 March 2026 | Viewed by 1617

Special Issue Editor


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Guest Editor
NYU Grossman School of Medicine, New York, NY, USA
Interests: GI pathology; pancreas pathology; liver pathology; diagnostic and prognostic biomarkers; digital pathology

Special Issue Information

Dear Colleagues,

Gastrointestinal (GI) cancers occur with high prevalence and mortality in the United States and worldwide. Early diagnosis and optimized therapy remain major challenges in the treatment of GI cancer. Personalized cancer therapy is a new approach that involves tailoring prevention and treatment recommendations to the individual patient based on their genetic/genomic characteristics and tumor-related biomarkers. Its evolution has instigated a new era in the fight against cancer.

Advancements in technology and molecular diagnostics have increased our understanding and interpretation of the genomic and proteomic properties of cancers, and revealed many specific biomarkers that are now being incorporated into diagnostic and treatment decision-making algorithms. Molecular pathology is rapidly becoming a cornerstone of personalized therapy for cancers, including GI cancers.

Digital pathology initiated the shift from traditional histopathology using microscopy to virtual images on the computer, and has promoted the use of artificial intelligence (AI) and machine learning (ML) by pathologists in clinical practice. AI in pathology comprises computational search algorithms, machine learning, and deep learning models. AI has been used to identify novel diagnostic and prognostic biomarker signatures on tissue images of various types of cancer, and has also been used to create more quantitative, detailed, objective, and reproducible assessments of these tissue biomarkers.

This Special Issue of Cancers aims to introduce the latest original studies and reviews on molecular biomarkers, digital pathology, and personalized therapy in GI cancers.

Dr. Wenqing Cao
Guest Editor

Manuscript Submission Information

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Keywords

  • molecular pathology
  • biomarkers
  • digital pathology
  • targeted therapy
  • gastric cancer
  • colon
  • liver
  • pancreas

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Published Papers (1 paper)

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Review

29 pages, 1029 KB  
Review
CLDN18.2-Targeted Therapy in Gastrointestinal Cancers
by Andrea Dominguez Wiscovitch, Ricardo J. Sanchez Mendez and Jennifer Chuy
Cancers 2025, 17(23), 3764; https://doi.org/10.3390/cancers17233764 - 25 Nov 2025
Viewed by 942
Abstract
Gastrointestinal cancers, including gastric, gastroesophageal junction, pancreatic, and biliary tract cancers, remain associated with poor outcomes due to late diagnosis and limited effective treatment options. Claudin-18.2 (CLDN18.2), a tight junction protein primarily found in the gastric epithelium and ectopically expressed in gastrointestinal tumors, [...] Read more.
Gastrointestinal cancers, including gastric, gastroesophageal junction, pancreatic, and biliary tract cancers, remain associated with poor outcomes due to late diagnosis and limited effective treatment options. Claudin-18.2 (CLDN18.2), a tight junction protein primarily found in the gastric epithelium and ectopically expressed in gastrointestinal tumors, has emerged as a promising therapeutic target across these diseases. This narrative review expands on existing discussions surrounding CLDN18.2-directed therapy in gastric and gastroesophageal cancer and provides a comprehensive, updated analysis of the rapidly evolving therapeutic landscape across multiple gastrointestinal malignancies, including pancreatic and biliary tract cancers. We summarize key developments following the approval of the monoclonal antibody zolbetuximab and critically evaluate emerging modalities, including bispecific antibodies, antibody–drug conjugates, and chimeric antigen receptor T-cell therapies, highlighting differences in mechanisms of action, efficacy, toxicity profiles, and mitigation strategies. We also discuss the clinical relevance of CLDN18.2 and PD-L1 co-expression, the rationale for pairing CLDN18.2-targeted therapy with immune checkpoint inhibitors, and early data supporting combination approaches. Additionally, we examine tumor heterogeneity, biomarker challenges, and emerging resistance mechanisms, alongside strategies to overcome them. Finally, we identify current limitations in the field, including inconsistent CLDN18.2 testing criteria, and outline prioritized future directions to optimize integration of CLDN18.2-directed therapies across gastrointestinal cancers. By looking beyond zolbetuximab and incorporating cross-platform comparison, immuno-oncology considerations, and multi-tumor context, this review provides a broad and forward-looking framework to guide clinical application and next-generation research in CLDN18.2-targeted therapy. Full article
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