4.7 Article

Circulating tumor DNA analyses predict progressive disease and indicate trastuzumab-resistant mechanism in advanced gastric cancer

Journal

EBIOMEDICINE
Volume 43, Issue -, Pages 261-269

Publisher

ELSEVIER SCIENCE BV
DOI: 10.1016/j.ebiom.2019.04.003

Keywords

Advanced gastric cancer; Circulating tumor DNA (ctDNA); Trastuzumab; Resistance mechanism; Monitoring

Funding

  1. National International Cooperation Grant [2014DFB33160]

Ask authors/readers for more resources

Background: Circulating tumor DNA (ctDNA) isolated from plasma contains genetic mutations that can be representative of those found in primary tumor tissue DNA. These samples can provide insights into tumoral heterogeneity in patients with advanced gastric cancer (AGC). Although trastuzumab has been shown to be effective in first-line therapy for patients with metastatic gastric cancer with overexpression of human epidermal growth factor receptor 2 (HER2), the mechanism of AGC resistance is incompletely understood. Methods: In this prospective study, we used targeted capture sequencing to analyze 173 serial ctDNA samples from 39 AGC patients. We analyzed cancer cell fractions with PyClone to understand the clonal population structure in cancer, and monitored serial samples during therapy. Serial monitoring of ctDNA using the molecular tumor burden index (mTBI), identified progressive disease before imaging results (mean: 18 weeks). Findings: We reconstructed the clonal structure of ctDNA during anti-HER2 treatment, and identified 32 expanding mutations potentially related to trastuzumab resistance. Multiple pathways activating in the same patients revealed heterogeneity in trastuzumab resistance mechanisms in AGC. In patients who received chemotherapy, mTBI was validated for the prediction of progressive disease, with a sensitivity of 94% (15/16). A higher mTBI (>= 1%) in pretreatment ctDNA was also a risk factor for progression-free survival. Conclusions: Analysis of ctDNA clones based on sequencing is a promising approach to clinical management, and may lead to improved therapeutic strategies for AGC patients. (C) 2019 The Authors. Published by Elsevier B.V.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

Article Immunology

CCND1Amplification Contributes to Immunosuppression and Is Associated With a Poor Prognosis to Immune Checkpoint Inhibitors in Solid Tumors

Yu Chen, Yingying Huang, Xuan Gao, Yi Li, Jing Lin, Lizhu Chen, Lianpeng Chang, Gang Chen, Yanfang Guan, Leong Kin Pan, Xuefeng Xia, Zengqing Guo, Jianji Pan, Yaping Xu, Xin Yi, Chuanben Chen

FRONTIERS IN IMMUNOLOGY (2020)

Article Oncology

Safety and Feasibility of Radiotherapy Plus Camrelizumab for Locally Advanced Esophageal Squamous Cell Carcinoma

Wencheng Zhang, Cihui Yan, Xuan Gao, Xiaoxia Li, Fuliang Cao, Gang Zhao, Jingjing Zhao, Puchun Er, Tian Zhang, Xi Chen, Yuwen Wang, Yao Jiang, Quanren Wang, Baozhong Zhang, Dong Qian, Jun Wang, Dejun Zhou, Xiubao Ren, Zhentao Yu, Lujun Zhao, Zhiyong Yuan, Ping Wang, Qingsong Pang

Summary: The study showed that radiotherapy plus anti-PD-1 antibody as first-line therapy for locally advanced esophageal squamous cell carcinoma is safe and feasible, with tumor-infiltrating and peripheral lymphocytes being associated with patient survival, suggesting potential for further exploration as a treatment option.

ONCOLOGIST (2021)

Article Genetics & Heredity

The prevalence of HLA-I LOH in Chinese pan-cancer patients and genomic features of patients harboring HLA-I LOH

Jian Zhao, Xiaoxiong Xiao, Yue Li, Xuan Gao, Xiuqin Zhang, Zeyi Liu, Yuting Yi, Xiaorui Fu, Han Wang, Yanfang Guan, Xuefeng Xia, Weixing Zhang, Jian'an Huang

Summary: HLA-I LOH prevalence varies across different cancer types, and is associated with genomic instability and higher tumor mutation burden levels. Enrichment of alterations in DNA damage response pathways and higher mutation rates of tumor suppressors are seen in HLA-I LOH cases. These findings may have implications for future tumor immunology research.

HUMAN MUTATION (2021)

Review Immunology

Immune checkpoint inhibitors for brain metastases in non-small-cell lung cancer: from rationale to clinical application

Gang Xiao, Zhiyuan Liu, Xuan Gao, Han Wang, Haiqin Peng, Jiahui Li, Lei Yang, Hexin Duan, Rongrong Zhou

Summary: Brain metastases are common in NSCLC patients and immune checkpoint inhibitors (ICIs) have become a routine treatment for these patients. Various ICIs have been approved for the first-line treatment of metastatic NSCLC, but the use of PD-L1, tumor infiltrating lymphocytes, and tumor mutation burden as predictive biomarkers for ICIs in NSCLC patients with BM remains controversial with insufficient clinical data.

IMMUNOTHERAPY (2021)

Article Oncology

RBM10 Deficiency Is Associated With Increased Immune Activity in Lung Adenocarcinoma

Bing Liu, Yaqi Wang, Han Wang, Zhongwu Li, Lujing Yang, Shi Yan, Xin Yang, Yuanyuan Ma, Xuan Gao, Yanfang Guan, Xin Yi, Xuefeng Xia, Jingjing Li, Nan Wu

Summary: The study demonstrates that RBM10 deficiency enhances anti-tumor immunity in lung adenocarcinoma, with higher HLA expression and immune cell infiltration, along with increased expression of certain immune checkpoint molecules.

FRONTIERS IN ONCOLOGY (2021)

Article Oncology

An Immune-Related Prognostic Signature for Predicting Clinical Outcomes and Immune Landscape in IDH- Mutant Lower-Grade Gliomas

Gang Xiao, Xuan Gao, Lifeng Li, Chao Liu, Zhiyuan Liu, Haiqin Peng, Xuefeng Xia, Xin Yi, Rongrong Zhou

Summary: A six-gene immune-related prognostic signature was developed for IDH-mutant LGGs, showing promising independent prognostic value and potential to enhance individualized therapy and clinical outcomes. The study also refined the classification system of IDH-mutant gliomas, stratifying patients into subtypes with distinct immunophenotypes and overall survival.

JOURNAL OF ONCOLOGY (2021)

Article Immunology

Immune Subtypes in LUAD Identify Novel Tumor Microenvironment Profiles With Prognostic and Therapeutic Implications

Feng Wang, Xuan Gao, Peiyuan Wang, Hao He, Peng Chen, Zhentian Liu, Yujie Chen, Hang Zhou, Weijie Chen, Xin Yi, Xuefeng Xia, Shuoyan Liu

Summary: In LUAD patients, the C3 inflammatory immune subtype is the most common and accurate prognostic subtype. It is associated with longer survival and has higher levels of immune cells and gene pathway expression, as well as lower levels of tumor-associated cells.

FRONTIERS IN IMMUNOLOGY (2022)

Article Oncology

Molecular underpinnings of exceptional response in primary malignant melanoma of the esophagus to anti-PD-1 monotherapy

Jie Dai, Xue Bai, Xuan Gao, Lirui Tang, Yu Chen, Linzi Sun, Xiaoting Wei, Caili Li, Zhonghui Qi, Yan Kong, Chuanliang Cui, Zhihong Chi, Xinan Sheng, Zelong Xu, Bin Lian, Siming Li, Xieqiao Yan, Bixia Tang, Li Zhou, Xuan Wang, Xuefeng Xia, Jun Guo, Lili Mao, Lu Si

Summary: In this study, the response and survival of patients with primary malignant melanoma of the esophagus (PMME) and non-esophageal mucosal melanoma (NEMM) under anti-PD-1 monotherapy were analyzed. PMME showed a better response to anti-PD-1 treatment compared to NEMM, with higher objective response rate and disease control rate. Genomic and transcriptome analyses revealed molecular differences between PMME and NEMM, supporting the distinct molecular characteristics of PMME.

JOURNAL FOR IMMUNOTHERAPY OF CANCER (2023)

Article Oncology

Heterogeneity of tumor immune microenvironment of EGFR/ALK-positive tumors versus EGFR/ALK-negative tumors in resected brain metastases from lung adenocarcinoma

Gang Xiao, Lifeng Li, Guilong Tanzhu, Zhiyuan Liu, Xuan Gao, Xin Wan, Desheng Xiao, Liu Chen, Xuefeng Xia, Rongrong Zhou

Summary: This study found that lung adenocarcinomas (LUAD) with EGFR-positive and ALK-positive had a suppressive tumor immune microenvironment (TIME) and were less responsive to immunotherapy. The TIME in patients with EGFR/ALK-positive LUAD brain metastases (BMs) was different from that in primary lung cancer. Evaluating the immune characteristics of LUAD BMs is important for clinical treatment.

JOURNAL FOR IMMUNOTHERAPY OF CANCER (2023)

No Data Available