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Gastric Cancer: D1/D2 and CRITICS study to explore the response and prognosis of different molecular subtypes of gastric cancer to neoadjuvant chemotherapy post hoc

 Last Update: 2022-03-05
 Source: Internet
 Author: User

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Epstein-Barr virus infection (EBV+) and high microsatellite instability (MSI-high) are resectableFavorable prognostic factors for survival in gastric cancer
(GC) patients .

However, the benefit of perioperative treatment in MSI-high tumor patients remains a topic of discussion

Epstein-Barr virus infection (EBV+) and high microsatellite instability (MSI-high) are resectableFavorable prognostic factors for survival in gastric cancer

The study included 447 patients treated with surgery in the D1/D2 study, and 451 patients treated with perioperative treatment in the CRITICS study, and tumor samples were used to determine EBV and MSI status
.

Correlations between pathological response, tumor morphological characteristics, and survival were explored

In the D1/D2 study, 47 (10.

In the D1/D2 study, 5-year tumor-related mortality (CRS) was 65.
2% in EBV+ patients, 56.
7% in MSI-high patients, and 47.
6% in EBV-/MSS patients (EBV+ compared with EBV−/MSS patients).
Patient HR=0.
57, 95CI 0.
31-0.
99, P = 0.
047; MSI-high patient HR=0.
78, 95%CI 0.
48-1.
27, P = 0.
32)
.

The 5-year OS rate was 51.

In the D1/D2 study, 5-year tumor-related mortality (CRS) was 65.

D1/D2 study on the differences of CRS and OS in different subtypes

D1/D2 studies the differences in CRS and OS of different subtypes D1/D2 studies the differences in CRS and OS of different subtypes

In the CRITICS study, 5-year CRS was 69.
8% in EBV+ patients, 51.
7% in MSI-high patients, and 38.
6% in EBV-/MSS patients (compared with EBV−/MSS patients) , HR=0.
44, 95% CI 0.
22-0.
88, P = 0.
02 for EBV+ patients; HR=0.
67, 95 CI 0.
37-1.
19, P = 0.
17 for MSI-high patients)
.

The 5-year OS rate was 56.

In the CRITICS study, 5-year CRS was 69.

CRITICS study of CRS and OS differences in different subtypes

In the CRITICS study, 2 patients with MSI-high showed (near) complete histopathological response after neoadjuvant chemotherapy (TRG1-2)
.

Five EBV+ tumors showed (near) complete histopathological responses (TRG1-2)

In the CRITICS study, 2 patients with MSI-high showed (near) complete histopathological response after neoadjuvant chemotherapy (TRG1-2)

Taken together, the study demonstrated that in resectable gastric cancer, patients with MSI-high subtype had a favorable prognosis compared with EBV-/MSS subtype, both in patients treated with surgery and in those receiving perioperative chemotherapy (radiotherapy) in patients
.
In resectable gastric cancer, patients with the MSI-high subtype have a favorable prognosis compared with the EBV-/MSS subtype, both in those treated with surgery, and in those receiving perioperative chemotherapy (radiation) in treated patients
.
In resectable gastric cancer, patients with the MSI-high subtype have a favorable prognosis compared with the EBV-/MSS subtype, both in those treated with surgery, and in those receiving perioperative chemotherapy (radiation) in treated patients
.

Original source:

Biesma HD, Soeratram TTD, Sikorska K, Caspers IA, van Essen HF, Egthuijsen JMP, Mookhoek A, van Laarhoven HWM, van Berge Henegouwen MI, Nordsmark M, van der Peet DL, Warmerdam FARM, Geenen MM, Loosveld OJL, Portielje JEA , Los M, Heideman DAM, Meershoek-Klein Kranenbarg E, Hartgrink HH, van Sandick J, Verheij M, van de Velde CJH, Cats A, Ylstra B, van Grieken NCT.
Response to neoadjuvant chemotherapy and survival in molecular subtypes of resectable gastric cancer: a post hoc analysis of the D1/D2 and CRITICS trials.
Gastric Cancer.
2022 Feb 7.
doi: 10.
1007/s10120-022-01280-2.
Epub ahead of print.
PMID: 35129727.

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