Translating Omics Profiling into Targeted Therapy for GI Cancers: Biomarkers, Resistance, and Trial-Ready Strategies

Gastrointestinal (GI) cancers — encompassing colorectal, gastric, pancreatic, hepatocellular, and oesophageal malignancies, among others — remain a leading cause of cancer-related mortality worldwide. Despite significant advances in high-throughput omics technologies, the translation of molecular discoveries into clinically actionable strategies continues to lag behind the pace of scientific progress. Bridging this gap requires not only robust biomarker identification, but a deeper understanding of the biological complexity that governs treatment response, resistance, and patient selection.This Research Topic provides a dedicated platform for research that moves omics profiling closer to clinical utility in GI oncology. We welcome contributions addressing the identification and validation of predictive and prognostic biomarkers derived from genomic, transcriptomic, proteomic, epigenomic, and metabolomic analyses. Of particular interest are studies that functionally interpret molecular alterations in the context of therapeutic decision-making — including the selection of targeted therapies, immunotherapies, and combination regimens informed by a patient’s molecular profile.A central theme of this collection is resistance — both intrinsic and acquired — to targeted and immune-based therapies. Contributions exploring the molecular mechanisms underpinning resistance, pathway crosstalk, tumour heterogeneity, and the role of the tumour microenvironment in shaping therapeutic outcomes are strongly encouraged. Research proposing rational, pathway-informed combination strategies or adaptive treatment approaches to circumvent resistance is particularly welcome.This Topic also highlights the critical role of clinical trial innovation in accelerating translation. Studies examining umbrella, basket, and platform trial designs, as well as biomarker-stratified and adaptive trial frameworks, are of great interest, as are real-world analyses that assess the implementation of precision oncology approaches in routine clinical practice.By bringing together expertise across molecular biology, translational oncology, bioinformatics, and clinical research, this Research Topic aims to advance the field of precision oncology in GI cancers — turning molecular profiles into clearer clinical decisions and, ultimately, better outcomes for patients. Topic editors: Simone Di Franco, SUDHIR KUMAR RAI Source: https://www.frontiersin.org/research-topics/80193/translating-omics-profiling-into-targeted-therapy-for-gi-cancers-biomarkers-resistance-and-trial-ready-strategies