Advances in Spatial Multi-Omics in Gastric Cancer

TL;DR

This review discusses how spatial multi-omics can better understand gastric cancer by capturing molecular and spatial details of tumors and their environment.

Contribution

The paper reviews advances in spatial multi-omics technologies and their potential to improve gastric cancer classification and treatment strategies.

Findings

Spatial multi-omics can reveal tumor heterogeneity and microenvironment interactions missed by traditional methods.

These technologies help identify new biomarkers and mechanisms of therapy resistance in gastric cancer.

Current challenges include technical limitations and the need for clinical translation of spatial profiling.

Abstract

Gastric cancer (GC) remains a major global health burden, with its unfavorable prognosis primarily driven by extensive tumor heterogeneity. Traditional bulk omics, while informative, are inherently limited by the averaging effect of diverse cell populations and fail to capture the critical spatial molecular disparities within the tumor and its microenvironment (TME). Single-cell omics can capture cellular heterogeneity but lack spatial context. Therefore, there is an urgent clinical need for spatial multi-omics to provide a high-definition dissection of GC heterogeneity and to optimize therapeutic efficacy. This review first outlines briefly the evolution of spatial technologies, including transcriptomics, proteomics, metabolomics, genomics and epigenomics, and their transformative applications in GC research. We further explore how these platforms refine molecular classification beyond traditional models, identify next-generation biomarkers, and decode the intricate cellular interactions governing immune evasion and metastasis. Next, we highlight the pivotal role of spatial profiling in unravelling the multidimensional mechanisms of resistance to chemotherapy, targeted therapy and immunotherapy. Finally, we address current technical bottlenecks and discuss prospects for clinical translation.

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