scholarly journals Prognostic Nutrition Index as Predictor for Nivolumab Monotherapy in Advanced Gastric Cancer Patients with Peritoneal Metastases.

2021 ◽  
Author(s):  
JUNGMIN LEE ◽  
Soo Ho Choi ◽  
Jin Ho Baek ◽  
Dong Won Baek ◽  
Jong Gwang Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Univariate Analysis ◽  
Predictive Biomarkers ◽  
Albumin Level ◽  
Peritoneal Metastases ◽  
Gastric Cancer Patients ◽  
The Relationship ◽  
Prognostic Nutrition Index

Abstract Although nivolumab shows survival benefits for patients with advanced gastric cancer (AGC), predictive biomarkers for nivolumab treatment in AGC remain unclear, especially in the case of peritoneal metastases. Therefore, this study investigated the clinical significance of the prognostic nutrition index (PNI), reflecting the host nutritional status and immunity, in AGC patients undergoing nivolumab monotherapy. This study retrospectively analyzed 53 AGC patients who received nivolumab between October 2017 and February 2021. Among them, 35 patients with peritoneal metastases were reviewed to investigate the relationship between the PNI and oncological outcomes. The PNI was calculated as 10 × serum albumin level (g/dl) + 0.005× total lymphocyte count (per mm3) at the first administration of nivolumab. With a median follow-up duration of 2.0 (0.3 − 13.5) months, the median overall survival (OS) was 2.0 months. The overall response and disease-control rates were 0.0% and 20.0%, respectively. Among the 35 patients, 13 patients were identified as a high-PNI group. In the univariate analysis, the high-PNI group showed a significantly longer PFS and OS than the low-PNI group. In the multivariate analysis, the high-PNI was independently associated with a longer PFS (p = 0.021) and OS (p = 0.022). The PNI can be useful for predicting PFS and OS in AGC patients with peritoneal metastases. However, further studies are required to validate these results in AGC and new strategies are needed to improve the outcome for AGC patients with peritoneal metastases.

scholarly journals Prognostic Significance of Serum Uric Acid and Gamma-Glutamyltransferase in Patients with Advanced Gastric Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Shanshan Yang ◽  
Xinjia He ◽  
Ying Liu ◽  
Xiao Ding ◽  
Haiping Jiang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Uric Acid ◽  
Prognostic Factors ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Serum Uric Acid ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Gamma Glutamyltransferase ◽  
Gastric Cancer Patients

Purpose. In this study, we aim to evaluate the prognostic role of serum uric acid and gamma-glutamyltransferase in advanced gastric cancer patients. Methods. A total of 180 patients pathologically diagnosed with advanced gastric cancer were included in this retrospective study. We used time-dependent receiver operating characteristic (ROC) curves to identify the optimal cut-off value of serum uric acid (UA) and gamma-glutamyltransferase (GGT). Survival analysis was performed using the Kaplan–Meier method and log-rank test, and multivariate Cox regression analyses were applied. A nomogram was formulated, and the calibration and discrimination of the nomogram were determined by calibration curve and concordance index (C-index). We validated the results using bootstrap resampling and a separate study on 60 patients collected from 2015 to 2017 using the same criteria in other medical center. Results. Both higher serum uric acid (>228 μmol/L) and higher gamma-glutamyltransferase (>14 U/L) had worse OS and PFS. Univariate analysis indicated that serum uric acid (UA) (p<0.001 and p<0.001) and gamma-glutamyltransferase (GGT) (p<0.001 and p=0.044) were significantly related to overall survival (OS) and progression-free survival (PFS), respectively. Multivariate analysis revealed serum uric acid (UA) and gamma-glutamyltransferase (GGT) were independent prognostic factors for OS (p=0.012, p=0.001). The optimal agreement between actual observation and nomogram prediction was shown by calibration curves. The C-indexes of the nomogram for predicting OS and PFS were 0.748 (95% CI: 0.70-0.79) and 0.728 (95% CI: 0.6741-0.7819), respectively. The results were confirmed in the validation cohort. Conclusion. We observed that both serum UA and GGT were poor prognostic factors in patients with advanced gastric cancer. And we also formulated and validated a nomogram which can predict individual survival for advanced gastric cancer patients.

Clinical significance of serum tumor marker for advanced gastric cancer with palliative chemotherapy: A retrospective study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15524-e15524
Author(s):  
Yahui Zhu ◽  
Baorui Liu ◽  
Jia Wei ◽  
Juan Du ◽  
Ju Yang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Retrospective Study ◽  
Advanced Gastric Cancer ◽  
Tumor Markers ◽  
Statistical Significance ◽  
Survival Rates ◽  
Hepatic Metastases ◽  
Predictive Biomarkers ◽  
Clinical Value ◽  
Gastric Cancer Patients

e15524 Background:The predictive value of tumor markers has been previously reported a lot. However, the studies focused on advanced gastric cancer are few. In this study, we tried to investigate the relationship between the tumor markers of advanced gastric cancer and clinical characteristics, therapeutic effect of chemotherapy, and prognosis. Methods:A retrospective study including 146 advanced gastric cancer who had not received any previous anticancer therapy was performed. Blood samples for CEA, AFP, CA125, CA72-4, CA242 and CA19-9 were taken from patients before chemotherapy and monthly during their treatments. Statistical analysis was performed to predict the clinical value of these tumor markers. Results:CEA yielded an ROC value of 0.621 in predicting lymph node metastasis in gastric cancer, which was significantly higher than any of other markers. CA125 had the highest sensitivity, specificity and accuracy in gastric cancer patients with peritoneal metastasis. AFP and CEA were more frequently positive in patients with hepatic metastases. The response rate of Decreasing group, Stable group and Increasing group based on CA19-9, CEA, CA72-4, CA125 and CA242 levels achieved statistical significance. Positive cases of CA125, CA242, CA19-9 and CA72-4 showed poor prognosis, and significant differences in 3 year-survival rates were observed for CA125 and CA242. Conclusions:We found that different tumor markers in gastric cancer indicated different metastasis sits. CEA, CA242, CA19-9, CA125 and CA72-4 are predictive biomarkers in evaluating the effectiveness of chemotherapy. The elevated CA125, CA242, CA19-9 and CA72-4 levels at diagnosed had association with shorter overall survivals, especially CA125 and CA242.

Helicobacter pylori infection as an independent prognostic factor for locally advanced gastric cancer with curative resection

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4562-4562
Author(s):  
S. Kang ◽  
Y. Hwang ◽  
H. Lee ◽  
S. Jeong ◽  
J. Choi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Advanced Gastric Cancer ◽  
Curative Resection ◽  
Locally Advanced ◽  
Infection Status ◽  
Type Iv ◽  
Locally Advanced Gastric Cancer ◽  
Gastric Cancer Patients

4562 Background: A few studies reported the association between helicobacter pylori (HP) infection and better overall survival (OS) in resected gastric cancer patients (pts). Methods: We investigated the HP infection status and its association with clinicopathologic characteristics in 210 locally advanced gastric cancer patients (stage IB: 18, II: 61, IIIA: 62, IIIB: 31, IV: 38) who underwent adjuvant chemotherapy (CTX) after curative resection (≥D2 dissection). HP infection status in hematoxlin and eosin stained peritumoral tissue was graded according to the updated Sydney System and categorized as HP(-) (normal or mild infection) and HP(+) (moderate or marked infection) (Am J Surg Pathol 20:1161, 1996). Twenty-two pts received 5-FU, doxorubicin (DOX) CTX (5- FU 500 mg/m2 weekly for 36 wks, DOX 40 mg/m2 q 3 weeks x 12) with or without OK432, while 188 pts underwent 5-FU, mitomycin-C (MMC), and polysaccharide-K (PSK) CTX (5-FU 500 mg/m2 weekly for 24 wks, MMC 8 mg/m2 q 6 wks x 4, PSK 3 g/day for 16 wks) (Br J Cancer 84:186, 2001, Hepatogastroenterol 54:290, 2007). Results: The median follow-up duration of survivors was 125 (107–155) months. HP (-) was significantly correlated with Bormann type IV, larger tumor size (>5.5cm),and stage IIIB. In univariate analysis, patients with HP(-) (104 pts) demonstrated significantly poor 10-year OS compared with those with HP (+) (106 pts) (15.9% vs. 87.7%, p<0.0001). HP(-) was associated with poor outcome in all stages except stage IB (p=0.075). In multivariate analysis, HP(-) was the most significant independent prognostic factor of poor OS (hazard ratio 9.646, 95% CI 5.407–17.206, p<0.0001) followed by advanced stage (p=0.032), Bormann type IV (p=0.037) and old age (p=0.015). Conclusions: HP infection status seems to have strong prognostic significance in locally advanced gastric cancer. HP (-) pts may need intensified adjuvant treatment and careful follow-up. No significant financial relationships to disclose.

scholarly journals Gastric transcatheter chemoembolization can resolve advanced gastric cancer presenting with obstruction

2020 ◽  
Author(s):  
Dong Peng ◽  
Kun Qian ◽  
Yuxi Cheng ◽  
Wei Tao ◽  
Ying-Ying Zou ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Median Time ◽  
Clinical Success ◽  
Outlet Obstruction ◽  
Minimal Invasive ◽  
Post Intervention ◽  
Significant Difference ◽  
Gastric Cancer Patients

Abstract Background Gastric transcatheter chemoembolization (GTC) is an interventional minimal invasive method, which has never been mentioned in the previous literature for advanced gastric cancer with obstruction. The purpose of this study was to evaluate its safety and efficacy in treating advanced gastric cancer with obstruction.MethodsAdvanced gastric cancer patients with obstruction who underwent GTC were retrospectively analysed from June 2017 to January 2020. Baseline information, peri-intervention data, and post-intervention follow-up information were collected. Clinical data obtained before and after the GTC were compared, and the survival of all patients was analysed.ResultForty-Two patients were included in this study. 42 (100%) patients achieved technical success, and 22 (52.4%) achieved clinical success. The median time of the GTC was 83 (30.0-180.0) minutes, and the median time of hospitalization after GTC was 3 (1-6) days. One patient experienced abdominal pain during and after GTC. Twenty (47.6%) of the 42 patients underwent gastrectomy after intervention. The pre-intervention gastric outlet obstruction scoring system(GOOSS) was 1 (0-1) and the post-intervention GOOSS was 2 (0-3) (p=0.000<0.05). The median follow-up time was 9.5 (3-35) months, and the overall survival time was 14 months. In the univariate survival analysis, a significant difference was observed between patients who did or did not undergo radical gastrectomy after GTC (p = 0.014<0.05).ConclusionsGTC is a safe and effective treatment, and furthermore, it could be an alternative method in treating advanced gastric cancer with obstruction.

Serum VEGF Per Platelet Count as a Prognosis Predicting Factor in Advanced Gastric Cancer Patients

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5467-5467
Author(s):  
Byung Soo Kim ◽  
Chul Won Choi ◽  
Seok Jin Kim
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Platelet Count ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Free Survival ◽  
Control Serum ◽  
Gastric Cancer Patients

Abstract Background: New blood vessel formation is a crucial step in the process of tumor growth and systemic metastasis. Recent studies have shown that VEGF expression not in tissues but in serum sample is correlated with tumor vascularity, and the high serum VEGF levels could predict poor prognosis in cancer patients. However there has been no data regarding the clinical and prognostic significance of serum VEGF levels per platelet count in advanced gastric cancer. In this study, we conducted a study to evaluate the prognostic implication of serum VEGF per platelet count in the patients with advanced gastric cancer. Methods: 111 patients with histologically confirmed gastric cancer, 35 patients with early gastric cancer were included and control serum samples were acquired from 25 healthy volunteers. The levels of VEGF were measured using human VEGF quantitative enzymelinked immunosorbent assay (ELISA). Survival curves were calculated using the Kaplan-Meier method and survival comparisons were made by the log rank test in metastatic gastric cancer. The Cox proportional hazards regression model was utilized for multivariate analyses after univariate analysis defined relevant prognostic variables. Results: The mean serum VEGF level was higher in the patients of AGC compared to those with EGC and controls (AGC 465 ± 315.8pg/ml; EGC 306 ± 97.8 pg/ml controls 230.8 ± 53.2 pg/ml, P&lt; 0.033). A trend toward a significant positive correlation between serum VEGF and platelet counts was observed in patients of AGC (r = 0.477, P = 0.000, Fig 2) and there was a significant correlation between serum VEGF levels and differentiation of tumor (p = 0.014), stage (p = 0.036). The overall survival (log rank, p =0.0432) and the progression free survival (median 4.5 vs. 8.9 months; log rank, p =0.0116) were significantly shorter in patients with high VEGF per platelet count (≥1.626 pg/106). In the multivarivate analysis, performance status (P=0.025), the presence of peritoneal carcinomatosis (P=0.006), serum VEGF per platelet (P=0.005) were found to be significantly associated with the short progression free survival Conclusions: This study demonstrated that serum VEGF per platelet count is correlated with short overall survival and progression free survival in advanced gastric cancer patients. Therefore, serum VEGF per platelet may be a useful marker for predicting the prognosis of advanced gastric cancer patients.

Tumor VEGF expression and serum VEGF levels are independent prognostic factors in curatively resected gastric cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4021-4021
Author(s):  
M. Pera ◽  
O. Vidal ◽  
J. Elizalde ◽  
A. Soriano ◽  
A. Volant ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Tumor Recurrence ◽  
Univariate Analysis ◽  
Vegf Expression ◽  
Gastric Cancer Patients ◽  
Resected Gastric Cancer ◽  
Related Survival

4021 Background: Increased serum and/or tumor vascular endothelial growth factor (VEGF) and urokinase-type plasminogen activator (uPA) have been shown to predict poor survival in several neoplasms, but their prognostic value in gastric cancer (GC) remains unknown. Methods: Serum VEGF (S-VEGF) and uPA concentrations were measured by commercially available ELISA in 20 healthy controls and 97 GC patients (70% I-II stages) before an R0 gastric resection. Tumor expression of VEGF and uPA were assessed by immunohistochemistry. Additional variables, including demographic, histological and therapeutic data were also evaluated. Univariate (Kaplan-Meier, log-rank test) and multivariate (Cox regression) analyses were performed to select prognostic factors regarding survival and tumor recurrence. Results: S-VEGF, but not uPA levels were significantly higher in GC patients than in controls. After a mean follow-up of 47 ± 3 months, the probability of cancer-related survival at 2, 5, and 10 years was 86%, 69% and 59%, respectively. Univariate analysis identified tumor VEGF expression (p=0.001) and high (> 289 pg/ml) S-VEGF levels (p=0.045), along with pTMN stage, grade of curability, perineural invasion, lymph node ratio, and extent of lymphadenectomy as variables associated with cancer-related survival. The mean disease-free survival was 20 ± 3 months, the probability of tumor recurrence being 78%, 62% and 62% at 2, 5 and 10 years, respectively. Prognostic variables for recurrence were the same as those identified for survival. Multivariate analysis identified tumor VEGF expression and high S-VEGF levels as independent prognostic survival factors. Conclusions: After a long follow-up, tumor VEGF expression and S-VEGF levels are independent prognostic factors for recurrence and survival in curatively resected gastric cancer patients. Such markers for increased angiogenic activity might help to identify patients at high risk of recurrence that could mostly benefit from adjuvant therapies. It is tempting to speculate that trials assessing the potential benefit of a.ntiangiogenic agents might be particularly warranted in patients with resected GC and a highly angiogenic phenotype. No significant financial relationships to disclose.

Serum proteomic profiling of advanced gastric cancer and identification of proteomic changes following response to epirubicin, cisplatin and capecitabine chemotherapy as diagnostic and predictive biomarkers

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4537-4537
Author(s):  
H. H. Helgason ◽  
J. Y. Engwegen ◽  
A. Cats ◽  
H. Boot ◽  
M. Kuiper ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Predictive Biomarkers ◽  
Healthy Controls ◽  
Proteomic Profiling ◽  
First Line ◽  
Response To Chemotherapy ◽  
Profile Changes ◽  
Gastric Cancer Patients

4537 Background: Gastric cancer is the fourth most commonly diagnosed cancer and is the second leading cause of cancer death worldwide. Prognosis is highly dependent on stage at diagnosis making early diagnosis mandatory. By using SELDI - TOF mass spectrometry we compared serum protein profiles of gastric cancer patients with healthy controls and those of gastric cancer patients responding to first-line ECC chemotherapy with those with no response or early progressive disease. Methods: Serum from patients with advanced gastric cancer (GC) was obtained, according to a predefined schedule, prior to start of first-line epirubicin (50 mg/m2 day 1), cisplatin (60 mg/m2 day 1) and capecitabine (1,000 mg/m2 d1–14) chemotherapy (ECC) and serially before each treatment cycle every 3 weeks and analyzed by standardized SELDI-TOF MS/MS. Serum proteomic profiles of GC patients were compared with those of matched healthy controls and proteomic profile changes in responding and non-responding patients were analyzed. Results: In total 82 patients (mean age 57 years) were treated with mean 5 ECC cycles resulting in a response rate of 35%, mean time to progression of 7.1 months and mean overall survival of 12.4 months (95% CI: 10.7 - 14.1). By comparing GC patients and healthy controls we identified 18 m/z values that significantly (p < 0.00001) differentiated between the two groups (m/z 2.7 - 66.6 kDa). Comparison of responding and non-responding patients identified 2 proteins, m/z 3109 and 7559 Da, potentially predicting response (p < 0.001). Serial analysis of proteins changing differently during chemotherapy according to response will be performed. Conclusions: We identified 18 m/z values/proteins that highly (p < 1.0 E-05) discriminated between gastric cancer patients and healthy controls serving as candidate biomarkers of gastric cancer and 2 m/z values that significantly predicted response to chemotherapy. No significant financial relationships to disclose.

Measuring transcripts of components of the BRCA1 DNA repair pathway, components of the hippo-YAP pathway, β-TrCP, HER2, AEG-1, EZH2 and other genes in advanced gastric cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4068-4068
Author(s):  
Jia Wei ◽  
Carlota Costa ◽  
Baorui Liu ◽  
Jose Javier Sanchez ◽  
Ana Gimenez Capitan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Dna Repair ◽  
Advanced Gastric Cancer ◽  
Close Correlation ◽  
Second Line ◽  
Her2 Positive ◽  
Low Levels ◽  
Gastric Cancer Patients ◽  
The Relationship ◽  
Gene Expression Levels

4068 Background: The primary goal of this study was to classify gastric cancer in two different sub-groups. We speculated that HER2-positive gastric cancers could be regulated by β-TrCP, while tumors unaffected by β-TrCP activation could be more dependent on the Hippo-YAP signaling pathway, in which TAZ increases the expression of AXL. Gastric cancer can overexpress AEG-1 and EZH2. The relationship between EZH2 and the Hippo-YAP pathway was explored in this study. We also explored BRCA1 complexes, including upstream components, such as 53BP1 and MMSET. Methods: Paraffin-embedded samples were collected from 132 advanced gastric cancer patients (p) treated with first-line FOLFOX, 58 of whom received second-line docetaxel-based treatment. Gene expression levels of HER2, β-TrCP, TAZ, AXL, EZH2, AEG-1, BRCA1, and genes involved in DNA repair pathways (RAP80, PIAS1, PIAS4, MDC1, 53BP1, MMSET, and UBC9) were quantified by real-time PCR. BIM, IDO, and SPINK1 were also examined. Results: A close correlation was found for the majority of the genes, for example, BRCA1-MMSET (rho=0.28; P=0.002) and AXL-TAZ (rho=0.58; P>0.001). Median overall survival (OS) was 12.5 months (m). Among the 58 p receiving second-line docetaxel, in p with high levels of BRCA1, OS was 24.9 m, while it was 19.1 m in p with intermediate levels and 9.5 m in p with low levels (P=0.009). OS was 28.6 in p with high levels of MMSET, 13.8 in p with intermediate levels and 12.3 in p with low levels (P=0.001). In the multivariate analysis, only BRCA1 was a significant marker for OS (Table). Conclusions: The study showed the predictive value of BRCA1, which could be useful for customizing chemotherapy with or without docetaxel. In addition, MMSET requires further study since it is involved in DNA repair upstream of BRCA1. [Table: see text]

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