Sa1443 Evaluation of the Response to Chemotherapy in Advanced Gastric Cancer by Contrast-Enhanced Harmonic EUS

e15621 Background: Though serum LDH level is frequently elevated in the patients with advanced gastric cancer, its clinical significance is still elusive. Moreover, the relationship between the change of serum LDH level after chemotherapy and the response to the treatment has not been studied, yet. We analyzed serum LDH level as a prognostic factor for the patients with advanced stomach cancer. Methods: We assessed serum LDH level before chemotherapy for the patients who were planned to receive palliative chemotherapy. We re-assessed their serum LDH level at the time when the response to chemotherapy was evaluated after 2–4 cycles of treatment. The survival duration and the response to chemotherapy for the patients with low serum LDH level were compared to the survival duration and the response to chemotherapy for the patients with high serum LDH level. The relationship between the change of serum LDH level and the response to the treatment was evaluated, too. Results: Total 118 patients were entered into this study and 114 patients were evaluable for their response to chemotherapy. Pre-treatment serum LDH level was normal in 88 patients and elevated in 30 patients. The response rate in the patients with high serum LDH level was significantly higher than the response rate in the patients with normal serum LDH level (34.5% versus 15.3%, p < 0.05). However, the patients with normal serum LDH level lived longer than the patients with high serum LDH level (median: 378 days versus 206 days, p < 0.001). The normalizing of the elevated serum LDH level after chemotherapy was related to the good response to treatment (response rate 50.0% versus 18.8%, p < 0.05). Conclusions: For the patients with advanced gastric cancer, high serum LDH level was related to better response to chemotherapy but shorter survival duration. The normalization of elevated serum LDH level after chemotherapy was related to good response to treatment. No significant financial relationships to disclose.

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Prognostic value of serum soluble programmed death-ligand 1 (sPDL1) and dynamics during chemotherapy in advanced gastric cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.4034 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 4034-4034 ◽

Cited By ~ 1

Author(s):

Woochan Park ◽

Ju-Hee Bang ◽

Ah-Rong Nam ◽

Ji Eun Park ◽

Mei Hua Kim ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Prognostic Value ◽

Soluble Form ◽

Enzyme Linked Immunosorbent Assay ◽

Programmed Death Ligand 1 ◽

Neutrophil Lymphocyte Ratio ◽

Programmed Death ◽

Response To Chemotherapy ◽

Line Chemotherapy

4034 Background: The soluble form Programmed Death-Ligand 1(sPDL1) is suggested to have immunosuppressive activity and under investigation as candidate biomarker for immuno-oncology drug development. In this study, we measured the serum sPDL1 at pre-and post-chemotherapy and evaluated its prognostic implication and dynamics during chemotherapy in advanced gastric cancer (GC). Methods: We prospectively enrolled 68 GC patients who were candidates for palliative standard 1st-line chemotherapy, and blood was serially collected at pre-and post-one cycle of chemotherapy, at best response and disease progression. sPDL1 was measured using an enzyme-linked immunosorbent assay. Response to chemotherapy, overall survival (OS), progression-free survival (PFS) and other prognostic factors including neutrophil-lymphocyte ratio (NLR) were obtained. The cut-off values of sPDL1 levels and changes for survivals were found using C-statistics. Results: The median baseline sPDL1 was 0.8ng/mL(range, 0.06 - 6.06ng/mL). The median OS and PFS were 14.9 months (95% CI: 7.33-22.47) and 8.0 months (95% CI: 5.96-10.0), respectively. sPDL1 and NLR showed a positive correlation. Patients with low levels of sPD-L1 at diagnosis ( < 1.92 ng/mL) showed a better OS and PFS than the patients with a high sPDL1 (OS: 18.3 vs. 95 months, P = 0.057, PFS: 8.9 vs. 6.0 months, P = 0.04). The baseline sPDL1 before treatment were higher in the PD group than in the SD and PR groups (mean:2.91, 1.17, 1.19, P = 0.019). Patients whose sPDL1 increased after 1st cycle of chemotherapy showed the tendency of worse PFS and OS. When disease progressed, sPDL1 increased compared with baseline (mean:1.31, 1.45, P = 0.029). Conclusions: sPDL1 at pre-chemotherapy confers the prognostic value for PFS and OS in GC patients under palliative 1st-line chemotherapy. The dynamics of sPDL1 during chemotherapy correlates with disease courses.

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Clinical Complete Response after Chemotherapy and Palliative Surgery for Unresectable Gastric Cancer

Case Reports in Oncology ◽

10.1159/000507781 ◽

2020 ◽

Vol 13 (2) ◽

pp. 689-695 ◽

Cited By ~ 1

Author(s):

Masayuki Shishida ◽

Kazuhiro Toyota ◽

Masahiro Ikeda ◽

Nozomi Karakuchi ◽

Masashi Inoue ◽

...

Keyword(s):

Gastric Cancer ◽

Computed Tomography ◽

Advanced Gastric Cancer ◽

Hepatic Metastases ◽

Complete Response ◽

Gastric Body ◽

Clinical Complete Response ◽

Response To Chemotherapy ◽

Unresectable Gastric Cancer ◽

Potassium Oxonate

Gastric cancer incidence is high in several countries, and management of advanced gastric cancer remains a challenge. Chemotherapy for unresectable gastric cancers is still evolving, and achieving a complete cure is difficult. Although a clinical complete response to chemotherapy has been reported in patients with unresectable gastric cancer, the chemotherapy duration for these patients is unclear. Here, we report the case of a 71-year-old man who presented with abdominal discomfort. Upper endoscopy revealed advanced gastric cancer on the upper gastric body. Histopathological examination revealed a poorly differentiated adenocarcinoma. Computed tomography revealed regional lymph node and multiple bilobar hepatic metastases. Radical surgery was not possible; therefore, palliative resection of the primary lesion was planned for symptomatic improvement. Tegafur, 5-chloro-2,4-dihydropyrimidine, and potassium oxonate were administered prior to surgery, and proximal gastrectomy was performed. Tegafur, 5-chloro-2,4-dihydropyrimidine, and potassium oxonate administration was reinitiated after surgery. A clinical complete response was achieved in the 8th postoperative month, with no hepatic metastases noted on radio imaging. Computed tomography performed in the 1st postoperative year revealed ascites; however, the cytological examination findings were negative. The initial chemotherapy was discontinued, and paclitaxel administration was commenced. Computed tomography performed annually thereafter demonstrated no recurrence, and paclitaxel was discontinued in the 9th postoperative year. The patient remained recurrence free at 12 years postoperatively. For elderly patients like the one presented here, it may be necessary to consider ceasing chemotherapy; however, because it is possible for a complete clinical response over the long term, it should be continued if the patient is well.

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Lauren subtypes of advanced gastric cancer influence survival and response to chemotherapy: real-world data from the AGAMENON National Cancer Registry

British Journal of Cancer ◽

10.1038/bjc.2017.245 ◽

2017 ◽

Vol 117 (6) ◽

pp. 775-782 ◽

Cited By ~ 27

Author(s):

Paula Jiménez Fonseca ◽

◽

Alberto Carmona-Bayonas ◽

Raquel Hernández ◽

Ana Custodio ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Cancer Registry ◽

Real World ◽

Real World Data ◽

World Data ◽

National Cancer Registry ◽

Response To Chemotherapy

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Use of circulating tumor cells to predict response to chemotherapy in patients with advanced gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.43 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 43-43

Author(s):

S. Matsusaka ◽

K. Chin ◽

N. Mizunuma ◽

M. Ogura ◽

M. Suenaga ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Cox Regression ◽

Performance Status ◽

Univariate Analysis ◽

Eastern Cooperative Oncology Group ◽

Cox Regression Analysis ◽

Response To Chemotherapy

43 Background: The purpose of this study was to quantify circulating tumor cells (CTCs) in advanced gastric cancer (AGC) patients, and to demonstrate the role of CTCs in cancer therapy. The purpose of this study was to identify CTC threshold proposal for determining response to chemotherapy in AGC. Methods: From November 2007 to June 2009, fifty-two patients with AGC were enrolled into a prospective study. All patients were enrolled using institutional review board-approved protocols at the Cancer Institute Hospital and provided informed consent. The study population consisted of patients of aged 18 years or older with histologically proven AGC. Other inclusion criteria were Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 2; adequate organ function. The subjects were five patients treated with S-1 (40 mg/m2, twice daily, days 1-28, repeated every 6 weeks), twenty-six patients treated with S-1 plus CDDP (S-1 40 mg/m2, twice daily, days 1-21, CDDP 60 mg/m2, day 8, repeated every 5 weeks), and twenty-one patients treated with paclitaxel (80 mg/m2, weekly). CTCs of whole blood at baseline, two weeks and four weeks after initiation of chemotherapy, were isolated and enumerated using immunomagnetics. Results: Patients with ≥4 CTCs at two-week points and four-week points had a shorter median PFS (1.4, 1.4 months, respectively), than those with the median PFS of <4 CTCs (4.9, 5.0 months, respectively) (p<0.001, p<0.001, respectively). Patients with ≥4 CTCs at two-week points and four-week points had shorter median OS (3.5, 4.0 months, respectively) than those with the median PFS of <4 CTCs (11.7, 11.4 months, respectively) (p<0.001, p=0.001, respectively). In univariate analysis, PS, treatment regimen, Line of chemotherapy, and CTC levels at 2 weeks and 4 weeks predicted PFS and OS. In order to evaluate the independent predictive effect of chemotherapy, multivariate Cox regression analysis was carried out. CTC levels at 2 weeks and 4 weeks were the strongest predictors. Conclusions: A threshold of lower than 4 CTC/7.5 ml at 2 weeks and 4 weeks was a significant predictor of the outcome for AGC patients treated with S-1 based regimen or paclitaxel regimen. No significant financial relationships to disclose.

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Impact of the immune cell population in peripheral blood on response and survival in patients receiving neoadjuvant chemotherapy for advanced gastric cancer

Tumor Biology ◽

10.1177/1010428317697571 ◽

2017 ◽

Vol 39 (5) ◽

pp. 101042831769757 ◽

Cited By ~ 5

Author(s):

Qi He ◽

Guoli Li ◽

Xiang Ji ◽

Long Ma ◽

Xulin Wang ◽

...

Keyword(s):

Gastric Cancer ◽

T Cells ◽

Neoadjuvant Chemotherapy ◽

Clinical Outcome ◽

Advanced Gastric Cancer ◽

Cd8 T Cells ◽

Peripheral Blood ◽

Immune Cell ◽

T Cell Subsets ◽

Response To Chemotherapy

We aimed to investigate the prognostic value of the immune cells population in peripheral blood from patients with advanced gastric cancer treated with neoadjuvant chemotherapy. A total of 105 patients with advanced gastric cancer were evaluated in this study. Blood samples were collected before and 1 week after the last dose of chemotherapy. The percentage of CD3+, CD3+CD4+, CD3+CD8+, and CD4+CD25+Foxp3+ T cells was assessed using flow cytometry analysis. The relationship between T cell subsets and clinical outcome was evaluated. The percentage of CD3+CD8+ lymphocytes was significantly increased after chemotherapy and CD4+CD25+Foxp3+ regulatory T cells (Tregs) decreased ( p = 0.003 and p < 0.001, respectively). The percentage of CD3+CD8+ lymphocytes and Tregs was strongly associated with response to chemotherapy ( p = 0.017 and p < 0.030, respectively). Patients with high CD3+CD8+ T cells and low CD4+CD25+Foxp3+ Tregs had significantly increased overall survival ( p = 0.012 and p = 0.048, respectively). Neither CD3+ nor CD3+CD4+ T cells showed significant changes after chemotherapy or correlations with the clinical outcome. The positive correlation between a high CD3+CD8+ T cells or low CD4+CD25+Foxp3+ Tregs and clinical outcome indicates its key role in the prognosis of gastric cancer patients and may serve as a biomarker to identify patients likely to benefit from neoadjuvant chemotherapy.

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