Positive Status of Epstein-Barr Virus as a Biomarker for Gastric Cancer Immunotherapy: A Prospective Observational Study
Positive Status of Epstein-Barr Virus as a Biomarker for Gastric Cancer Immunotherapy: A Prospective Observational Study
复制标题
DOI：
10.1097/cji.0000000000000316
复制
发表时间：
2020-05-01
影响因子：
3.9
通讯作者：
Peng, Zhi
中科院分区：
文献类型：
--
作者：
Xie, Tong;Liu, Yiqiang;Peng, Zhi
免疫疗法在胃癌中显示出有希望但有争议的结果；确定选择适当目标人群的标准仍然存在问题。eb病毒（EBV）相关性胃癌（EBVaGC）表现出独特的基因组畸变和临床病理特征，EBV阳性状态是一种潜在的生物标志物。我们前瞻性地招募了9名诊断为iv期EBVaGC的患者，所有患者均接受免疫检查点抑制剂治疗。患者的中位年龄为62岁。临床病理特征显示EBVaGC以男性为主，分化程度较差。淋巴结被证明是最常见的转移部位。免疫化学和聚合酶链反应分析显示，所有患者都具有熟练的错配修复能力，其中7例患者检测到微卫星不稳定稳定和程序性细胞死亡配体1。3例程序性细胞死亡配体1阳性患者部分缓解，5例病情稳定，1例无明显病变患者免疫治疗后腹水及肿瘤标志物水平下降。到最后一次随访时，最长的反应持续时间为18个月。EBVaGC具有独特的临床病理特征，ebv阳性状态可能是胃癌免疫治疗的潜在生物标志物。
Immunotherapy has exhibited promising but controversial results in gastric cancer; determining criteria for choosing the appropriate target population is still problematic. Epstein-Barr virus (EBV)-associated gastric carcinoma (EBVaGC) exhibits distinctive genomic aberrations and clinicopathologic features, the positive status of EBV is a potential biomarker. We prospectively recruited 9 patients who were diagnosed with stage-IV EBVaGC, and all of the patients were treated by immune-checkpoint inhibitors. The median age of the patients was 62 years old. The clinicopathologic characteristics demonstrated a male predominance and poor differentiation status of EBVaGC. Lymph nodes were demonstrated to represent the most common metastatic site. Immunochemistry and polymerase chain reaction analysis revealed that all of the patients were proficient mismatch repair, and microsatellite instability-stable and programmed cell death-ligand 1 were detected in 7 patients. Three patients with positive programmed cell death-ligand 1 showed partial response, 5 patients showed stable disease, 1 patient without measurable lesion showed decreasing ascites and tumor marker level after immunotherapy. The longest duration of response was 18 months by the time of the last follow-up. EBVaGC exhibits distinctive clinicopathologic characteristics, and EBV-positive status may be a potential biomarker for gastric cancer immunotherapy.