scholarly journals Novel Biomarkers of Gastric Adenocarcinoma: Current Research and Future Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5660
Author(s):  
Nadja Niclauss ◽  
Ines Gütgemann ◽  
Jonas Dohmen ◽  
Jörg C. Kalff ◽  
Philipp Lingohr
Keyword(s):  
Gastric Cancer ◽  
Checkpoint Inhibitors ◽  
Therapy Monitoring ◽  
Treatment Strategies ◽  
Transcriptome Profiling ◽  
Risk Scores ◽  
Prognostic Indicators ◽  
Stromal Microenvironment ◽  
Proven Efficacy ◽  
Gastric Cancer Patients

Overall survival of gastric cancer remains low, as patients are often diagnosed with advanced stage disease. In this review, we give an overview of current research on biomarkers in gastric cancer and their implementation in treatment strategies. The HER2-targeting trastuzumab is the first molecular targeted agent approved for gastric cancer treatment. Other promising biomarkers for targeted therapies that have shown relevance in clinical trials are VEGF and Claudin 18.2. Expression of MET has been shown to be a negative prognostic factor in gastric cancer. Targeting the PD-1/PD-L1 pathway with immune checkpoint inhibitors has proven efficacy in advanced gastric cancer. Recent technology advances allow the detection of circulating tumor cells that may be used as diagnostic and prognostic indicators and for therapy monitoring in gastric cancer patients. Prognostic molecular subtypes of gastric cancer have been identified using genomic data. In addition, transcriptome profiling has allowed a comprehensive characterization of the immune and stromal microenvironment in gastric cancer and development of novel risk scores. These prognostic and predictive markers highlight the rapidly evolving field of research in gastric cancer, promising improved treatment stratification and identification of molecular targets for individualized treatment in gastric cancer.

Prognostic indicators in node-negative advanced gastric cancer patients

2010 ◽  
Vol 101 (7) ◽  
pp. 622-625 ◽  
Author(s):  
Hiroaki Saito ◽  
Hirohiko Kuroda ◽  
Tomoyuki Matsunaga ◽  
Kenji Fukuda ◽  
Shigeru Tatebe ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Prognostic Indicators ◽  
Node Negative ◽  
Gastric Cancer Patients

scholarly journals Application of Data Mining for the Prediction of Mortality and Occurrence of Complications for Gastric Cancer Patients

Entropy ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. 1163 ◽  
Author(s):  
Cristiana Neto ◽  
Maria Brito ◽  
Vítor Lopes ◽  
Hugo Peixoto ◽  
António Abelha ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Data Mining ◽  
Cancer Patients ◽  
Healthcare Delivery ◽  
Treatment Strategies ◽  
Data Mining Algorithms ◽  
Prediction Of Mortality ◽  
Hospital Stays ◽  
Gastric Cancer Patients ◽  
Mining Algorithms

The development of malign cells that can grow in any part of the stomach, known as gastric cancer, is one of the most common causes of death worldwide. In order to increase the survival rate in patients with this condition, it is essential to improve the decision-making process leading to a better and more efficient selection of treatment strategies. Nowadays, with the large amount of information present in hospital institutions, it is possible to use data mining algorithms to improve the healthcare delivery. Thus, this study, using the CRISP methodology, aims to predict not only the mortality associated with this disease, but also the occurrence of any complication following surgery. A set of classification models were tested and compared in order to improve the prediction accuracy. The study showed that, on one hand, the J48 algorithm using oversampling is the best technique to predict the mortality in gastric cancer patients, with an accuracy of approximately 74%. On the other hand, the rain forest algorithm using oversampling presents the best results when predicting the possible occurrence of complications among gastric cancer patients after their in-hospital stays, with an accuracy of approximately 83%.

scholarly journals Expression of Human Epidermal Growth Factor Receptor-2 Status and Programmed Cell Death Protein-1 Ligand Is Associated With Prognosis in Gastric Cancer

2021 ◽  
Vol 10 ◽  
Author(s):  
Huifang Lv ◽  
Junling Zhang ◽  
Keran Sun ◽  
Caiyun Nie ◽  
Beibei Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
T Cells ◽  
Checkpoint Inhibitors ◽  
Growth Factor Receptor ◽  
Progression Free Survival ◽  
Underlying Mechanism ◽  
Tumor Location ◽  
The Cancer Genome Atlas ◽  
Prognostic Indicators ◽  
Her 2

BackgroundPD-L1 and HER-2 are routine biomarkers for gastric cancer (GC). However, little research has been done to investigate the correlation among PD-L1, HER-2, immune microenvironment, and clinical features in GC.MethodsBetween January 2013 and May 2020, a total of 120 GC patients treated with chemotherapy were admitted to Henan Tumor Hospital. We retrospectively identified PD-L1, HER-2 level before chemotherapy and abstracted clinicopathologic features and treatment outcomes. Univariate and multivariate survival analyses were performed to assess the relationship between PD-L1/HER-2 levels and progression-free survival (PFS). The mRNA and tumor microenvironment of 343 patients with GC from The Cancer Genome Atlas (TCGA) were used to explore the underlying mechanism.ResultsWe retrospectively analyzed 120 patients with gastric cancer, including 17 patients with HER-2 positive and 103 patients with HER-2 negative GC. The results showed that the expression of PD-L1 was closely correlated with HER-2 (P = 0.015). Patients with PD-L1/HER-2 positive obtained lower PFS compared to PD-L1/HER-2 negative (mPFS: 6.4 vs. 11.1 months, P = 0.014, mPFS: 5.3 vs. 11.1 months, P = 0.002, respectively), and the PD-L1 negative and HER-2 negative had the best PFS than other groups (P = 0.0008). In a multivariate model, PD-L1 status, HER-2 status, tumor location, and tumor differentiation remained independent prognostic indicators for PFS (P < 0.05). The results of database further analysis showed that the proportion of PD-L1+/CD8A+ in HER-2 negative patients was higher than that in HER-2 positive patients (37.6 vs 20.3%), while PD-L1−/CD8A− was significantly higher in HER-2 positive patients than HER-2 negative patients (57.8 vs. 28.8%). In addition, it showed that not only CD4+T cells, macrophages, and CD8+T cells, but also the associated inflammatory pathways such as IFN-γ/STAT1 were associated with HER-2.ConclusionHER-2 status could predict the efficacy of immune checkpoint inhibitors, and HER-2 status combined with PD-L1 level could predict the prognosis of GC patients.

REVIVE study: a prospective observational study in chemotherapy after nivolumab therapy for advanced gastric cancer

2020 ◽  
Author(s):  
Yukiya Narita ◽  
Hirokazu Shoji ◽  
Sadayuki Kawai ◽  
Takuro Mizukami ◽  
Michio Nakamura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Checkpoint Inhibitors ◽  
Objective Response ◽  
Cytotoxic Chemotherapy ◽  
Clinical Trial Registration ◽  
Heavily Pretreated ◽  
Pretreated Patients ◽  
Gastric Cancer Patients ◽  
To Receive

Nivolumab is an increasingly used standard care treatment for heavily pretreated patients with advanced gastric cancer, with increasing clinical use in Japan. Data from retrospective studies on various tumors have shown the objective response rate to cytotoxic chemotherapy potentially improves after an exposure to immune checkpoint inhibitors. Based on these data, we conducted the multicenter observational REVIVE study to evaluate the efficacy and safety of cytotoxic chemotherapy in nivolumab-refractory or nivolumab-intolerant patients with advanced gastric cancer. Patients who are refractory or intolerant to nivolumab and scheduled to receive irinotecan monotherapy, oxaliplatin combination treatment or oral trifluridine/tipiracil hydrochloride therapy will be included. The primary end point is overall survival of nivolumab-pretreated patients with advanced gastric cancer after the cytotoxic chemotherapy. Clinical trial registration: UMIN000032182.

Treatment outcomes of peritoneal carcinomatosis arising from gastric cancer with no measurable disease using systemic chemotherapy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14558-e14558
Author(s):  
Guk Jin Lee ◽  
Sook Hee Hong ◽  
Sang Young Roh ◽  
Young Seon Hong ◽  
Kyo Young Song ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Trials ◽  
Peritoneal Carcinomatosis ◽  
Systemic Chemotherapy ◽  
Treatment Strategies ◽  
Response Assessment ◽  
Low Grade ◽  
High Grade ◽  
Measurable Disease ◽  
Gastric Cancer Patients

e14558 Background: Although many clinical trials of newly developed chemotherapeutic drugs have been conducted, limited studies have focused on gastric cancer patients specifically diagnosed with peritoneal carcinomatosis (PC) without measurable regions. In the current study, we characterized the outcomes of systemic chemotherapy and prognostic factors for patients with gastric cancer PC, particularly in cases without measurable disease. Methods: Clinical data from 211 gastric cancer PC patients (137 without and 74 with measurable disease) subjected to systemic chemotherapy between January 2000 and December 2010 at a single center were reviewed. Results: Median OS rates of gastric cancer PC patients with no measurable disease were significantly longer than those of patients with measurable disease (18.2 vs 12.0 months, p=0.011). In multivariate analysis, poor PS (Hazard ratio (HR) = 2.33, 95% CI, 1.42-3.8, P=0.001), presence of metastatic lymphadenopathy (LAP) (HR=2.23, 95% CI, 1.42-3.5, p=0.002) and high-grade PC (HR=1.82, 95% CI, 1.09-3.04, p=0.025) were associated with significantly decreased OS. Combined with clinical PC grade and measurability of disease, median OS of patients with low-grade PC without measurable disease was 19.6 months (95% CI, 15.5-23.7 months). Median OS rates of 12.6, 13.7 and 6.8 months were estimated in high-grade PC without measurable disease, low-grade PC with measurable disease, and high-grade PC with measurable disease, respectively. Median OS of low-grade PC patients with no measurable disease was significantly higher than that of patients in all other groups (p=0.001, p=0.029 and p<0.001, respectively). Conclusions: Gastric cancer PC is a heterogeneous disease entity. In our study, clinically low-grade PC without measurable disease was associated with better outcomes than other groups following systemic chemotherapy. According to the carcinomatosis grade, specific groups of patients may benefit from systemic chemotherapy. Despite the difficulties of response assessment, further clinical trials for newer treatment strategies and molecular studies focusing on the heterogeneity of gastric cancer PC should be introduced.

Clinical features, treatments and survival of HER2 positive gastric cancer with elevated alpha-fetoprotein: An analysis of 16 cases.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16000-e16000
Author(s):  
Shaohua Ge ◽  
Yi Ba ◽  
Ting Deng ◽  
Yuchong Yang ◽  
Tao Ning ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Immune Checkpoint ◽  
Clinical Characteristics ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Elevated Serum ◽  
Her2 Positive ◽  
The Mean ◽  
Gastric Cancer Patients

e16000 Background: Gastric cancer with elevated alpha-fetoprotein (AFP) is a special type of gastric cancer with elevated serum AFP. It is often misdiagnosed as primary hepatic cancer due to abnormal AFP and liver metastasis. The AFP level is related to the prognosis of these patients in whom there is prone to high HER2 positive rate. Therefore, anti-HER2 treatment is optional, as well as the emerging immunotherapy with immune checkpoint inhibitors. Methods: Gastric cancer patients with HER2 and serum AFP examination were collected in our hospital from May 2017 till now. Serum AFP level over 7 ng/ml was defined as elevated AFP. The clinical characteristics, treatments and survival of the patients with HER2 positive and elevated AFP were picked and analyzed. Results: Among 135 gastric cancer patients with elevated AFP, 16 (11.9%) were HER-2 positive (12 with HER2 3+, 3 with HER2 2+/FISH+ and 1 with HER2 gene amplification in NGS). The mean serum AFP is 201.4± 476.7ng/ml (range: 7.74 -1335). There were 9 males and 7 females. The mean age was 55 years (range: 38-90). The tumors were located in stomach cardia and fundus in 5 cases, body in 5 cases, antrum in 4 cases, body and antrum in 1 case and whole stomach in 1 case. There were 2 patients in stage III and 14 patients in stage IV with metastasis to lymph node metastasis in 15, liver in 9, abdominal cavity in 3 and peritoneum in 3. As for the treatments, three patients underwent surgery, one of whom with exploratory laparotomy (no antitumor treatment after surgery, died from infection). In 13 advanced patients, 12 patients received systemic antitumor therapies (8 with chemotherapy+Trastuzumab+ immunotherapy, 2 with chemotherapy+Trastuzumab, 1 with chemotherapy+ immunotherapy and 1 with chemotherapy). The chemotherapy regimens were XELOX in 5 cases, SOX in 4 cases and FLOT in 2 cases. The response rate was 50% (6 in 12 patients) and the disease control rate was 100%. The median PFS was 7.5 months in first line therapy with six patients without progression disease yet. The longest PFS with PR lasted for 16.5 months with chemotherapy, trastuzumab and immune checkpoint inhibitor. Conclusions: Gastric cancer with HER2 positive and elevated serum AFP is a disease with special clinical characteristics. Patients with advanced diseases can be treated with chemotherapy, trastuzumab +/- immune checkpoint inhibitors. This combination is expected to become a new regimen to improve survival of such special patients.

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