Hypoxia-induced acidic microenvironment alters cellular pharmacokinetics of gastric cancer in a Mongolian population

The current study aimed to comprehensively analyze the transcriptional characteristics of Mongolian gastric cancer (GC) patients, elucidate the critical molecular events underlying treatment response in this population, and establish connections between these molecular events and the cellular pharmacokinetics of chemotherapy drugs. Our investigation revealed increased activation of the hypoxia pathway in GC tumor tissues from Mongolian individuals, and this activation was significantly associated with adverse prognosis. Through analysis of hypoxia-induced changes in cellular pharmacokinetics, we identified three chemotherapy drugs—paclitaxel, oxaliplatin, and tegafur–gimeracil–oteracil potassium capsules—that exhibit distinct transport and metabolic characteristics in GC tumor cells of Mongolian patients. These findings provide valuable insights for clinical practice, particularly in refining treatment strategies and advancing personalized medicine for Mongolian GC patients.