[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-356805-105":59,"doc-detail-356805-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","divergent-clonal-evolution-and-tumor-microenvironment-remodeling-shape-gastric-cancer-peritoneal-metastasis","Divergent clonal evolution and tumor microenvironment remodeling shape gastric cancer peritoneal metastasis","","Gastric cancer peritoneal metastasis (GCPM) is a clinically aggressive entity with poor outcomes and limited treatments, requiring a molecular understanding to enable better therapies. Whole-genome and transcriptome sequencing was performed on GCPM samples and partially paired primary gastric cancer tissues from 14 and 26 patients. Results show substantial intra- and inter-patient heterogeneity, divergent clonal evolution, and poor tumor microenvironment conservation. Desert-type primaries often shift toward immune-enriched metastasis microenvironments, suggesting immunotherapy resistance may stem from peritoneal-plasma barrier limitations. Findings support GCPM-specific stratification and novel treatment strategies.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/divergent-clonal-evolution-and-tumor-microenvironment-remodeling-shape-gastric-cancer-peritoneal-metastasis/356805/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/divergent-clonal-evolution-and-tumor-microenvironment-remodeling-shape-gastric-cancer-peritoneal-metastasis/356805.png","ImageObject",300,407,{"name":92,"@type":93},"Chumphorn","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What does the study investigate about gastric cancer peritoneal metastasis (GCPM)?","Question",{"text":113,"@type":114},"It examines molecular and tumor microenvironment differences between GCPM and partially paired primary gastric cancer tissues using whole-genome and transcriptome sequencing.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What major patterns of heterogeneity are reported in GCPM?",{"text":118,"@type":114},"The analysis finds substantial intra-patient heterogeneity and variability between patients, including differences in mutational overlaps and functional signatures between GCPM and primary tumors.",{"name":120,"@type":111,"acceptedAnswer":121},"How does the tumor microenvironment (TME) differ between primary tumors and GCPM?",{"text":122,"@type":114},"The TME is poorly conserved between primary gastric cancer and GCPM, with desert-type primary tumors often transitioning to immune-enriched TMEs in metastases.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},356805,1790275583,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":36},2336475401981,"https://ap-avatar.wpscdn.com/avatar/22000c94efd8d5204d?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786935347598174694","communications biology Article  \n\n| A Nature Portfolio journal |  | |\n| --- | --- | --- |\n| [https://doi.org/10.1038/s42003-026-09906-2](https://doi.org/10.1038/s42003-026-09906-2) |  |  |\n| Divergent clonal evolution and tumor microenvironment remodeling shape gastric cancer peritoneal metastasis\u003Cbr> Check for updates |  |  |\n| Clémentine Charton1,9, So Hyun Kang2,9, Stephanie S. Kim1, Minsu Kang3, Ju Hyun Lee3, Young Suk Park2, Sang-Hoon Ahn2, Yun-Suhk Suh2, Nak Jung Kwon4, Kyoung Un Park 5,6, Jieun Lee 2 ,\u003Cbr>Jinho Kim 1,5,7  & Hyung-Ho Kim 2,8  |  |  |\n| Gastric cancer peritoneal metastasis (GCPM) is a distinct clinical entity with a poor prognosis, characterized by aggressive features and limited treatment options. Understanding its molecular biology is critical for developing effective therapies. We performed whole genome and transcriptome sequencing on GCPM samples and partially paired primary gastric cancer (GC) tissues from 14 and 26 patients, respectively. Our analysis reveals substantial intra-patient heterogeneity between GCPM and primary tumors at both genetic and functional levels. Inter-patient variability is observed in mutational overlaps, with some signatures unique to either GCPM or primary tumors. Tumor evolution analysis suggests divergent clonal evolution, with distinct clones specific to GCPM or primary tumorsin most patients. Transcriptomic profile reveals a high heterogeneity in the primary tumors, with five tumors presenting GCPM characteristics. The tumor microenvironment (TME) is poorly conserved between primary GC and GCPM, with desert-type primary tumors often transitioning to immuneenriched TMEs in metastases. These findings suggest that immunotherapy resistance in GCPM mayarise from factors beyond intrinsic TME characteristics, such as limited drug delivery due to the peritoneal-plasma barrier. Collectively, our results highlight significant molecular and TME heterogeneity between GCPM and primary tumors, emphasizing the need for GCPM-specificstratification and innovative treatment strategies to improve outcomes. |  |  |\n| Gastric cancer (GC) is the fifth most common cancer worldwide and the fourth leading cause of cancer-related death, with a particularly high prevalence in East Asia1. Despite advances in early diagnosis and treatment, metastatic gastric cancer continues to have a remarkably poor prognosis. Among metastatic patterns, gastric cancer peritoneal metastasis (GCPM) represents a distinct clinical entity characterized by aggressive features anda median survival of less than one year2. The peritoneum is a frequent site of metastasis, occurring in nearly one-third of patients at diagnosis, and is associated with significant morbidity and poor outcomes2. Even after curative resection, peritoneal metastases are the most common type of | recurrence, contributing to treatment failure and poor survival3. Incases of macroscopic peritoneal carcinomatosis, the prognosis is particularly dismal, with a median overall survival of only 3 to 6 months4.\u003Cbr>GCPM presents unique challenges in clinical management. Conventional imaging techniques often fail to detect peritoneal metastases, necessitating advanced staging modalities such as diagnostic laparoscopy or cytology washing for accurate diagnosis5. Furthermore, the biological and molecular characteristics of GCPM remain poorly understood due to the limited availability of tissue samples. Metastasis to the peritoneum is thought to result from the direct seeding of cancer cells into the peritoneal |  |\n\n1Precision Medicine Center, Future Innovation Research Division, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 2Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 3Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 4Precision Medicine Institute, Macrogen Inc, Seoul, Republic of Korea. 5Department of Laboratory Medicine, Seoul National","cbCaie90OAu3mFej","https://ap.wps.com/l/cbCaie90OAu3mFej","pdf",3690474,16,"English","# Gastric cancer peritoneal metastasis and clinical challenges\n## Study approach and sequencing design\n## Key findings: heterogeneity and clonal evolution\n## Tumor microenvironment remodeling and implications for therapy\n## Background: diagnosis and treatment limitations","[{\"question\":\"What does the study investigate about gastric cancer peritoneal metastasis (GCPM)?\",\"answer\":\"It examines molecular and tumor microenvironment differences between GCPM and partially paired primary gastric cancer tissues using whole-genome and transcriptome sequencing.\"},{\"question\":\"What major patterns of heterogeneity are reported in GCPM?\",\"answer\":\"The analysis finds substantial intra-patient heterogeneity and variability between patients, including differences in mutational overlaps and functional signatures between GCPM and primary tumors.\"},{\"question\":\"How does the tumor microenvironment (TME) differ between primary tumors and GCPM?\",\"answer\":\"The TME is poorly conserved between primary gastric cancer and GCPM, with desert-type primary tumors often transitioning to immune-enriched TMEs in metastases.\"}]","Divergent clonal evolution and tumor microenvironment remodeling shape gastric cancer peritoneal metastasis | PDF",1790127377]