Latin-America (LATAM) is the second region in gastric cancer incidence; gastric adenocarcinoma (GA) represents 95% of all cases. We provide a mutational landscape of GA highlighting a) germline pathogenic variants associated with hereditary GA

b) germline risk variants associated with sporadic GA

and c) somatic variants present in sporadic GA in LATAM

and analyze how this landscape can be applied for precision medicine. We found that Brazil

Chile

Colombia

Mexico

Peru

and Venezuela are the countries with more published studies from LATAM explicitly related to GA. Our analysis displayed that different germline pathogenic variants for the

CDH1

gene have been identified for hereditary GA in Brazilian

Chilean

Colombian

and Mexican populations. An increased risk of developing somatic GA is associated with the following germline risk variants:

IL-4

IL-8

TNF-α

PTGS2

NFKB1

RAF1

KRAS

and

MAPK1

in Brazilian;

IL-10

in Chilean;

IL-10

in Colombian;

EGFR

and

ERRB2

in Mexican

TCF7L2

and Chr8q24 in Venezuelan population. The path from mutational landscape to precision medicine requires four development levels: 1) Data compilation

2) Data analysis and integration

3) Development and approval of clinical approaches

and 4) Population benefits. Generating local genomic information is the initial padlock to overcome to generate and apply precision medicine.