The Gastric Cancer Registry: A Genomic Translational Resource for Multidisciplinary Research in Gastric Cancer

Background: Gastric cancer is a leading cause of cancer mor-bidity and mortality. Developing information systems which inte-grate clinical and genomic data may accelerate discoveries to improve cancer prevention, detection, and treatment. To support translational research in gastric cancer, we developed the Gastric Cancer Registry (GCR), a North American repository of clinical and cancer genomics data. Methods: Participants self-enrolled online. Entry criteria into the GCR included the following: (i) diagnosis of gastric cancer, (ii) history of gastric cancer in a first-or second-degree relative, or (iii) known germline mutation in the gene CDH1. Participants provided demographic and clinical information through a detailed survey. Some participants provided speci-mens of saliva and tumor samples. Tumor samples underwent exome sequencing, whole-genome sequencing, and transcrip-tome sequencing. Results: From 2011 to 2021, 567 individuals registered and returned the clinical questionnaire. For this cohort 65% had a personal history of gastric cancer, 36% reported a family history of gastric cancer, and 14% had a germline CDH1 mutation. 89 patients with gastric cancer provided tumor samples. For the initial study, 41 tumors were sequenced using next-generation sequencing. The data was analyzed for cancer mutations, copy-number varia-tions, gene expression, microbiome, neoantigens, immune infil-trates, and other features. We developed a searchable, web-based interface (the GCR Genome Explorer) to enable researchers' access to these datasets. Conclusions: The GCR is a unique, North American gastric cancer registry which integrates clinical and genomic annotation.Impact: Available for researchers through an open access, web-based explorer, the GCR Genome Explorer will accelerate collab-orative gastric cancer research across the United States and world.