Early assessment of circulating exosomal lncRNA-GC1 for monitoring neoadjuvant chemotherapy response in gastric cancer.
Early assessment of circulating exosomal lncRNA-GC1 for monitoring neoadjuvant chemotherapy response in gastric cancer.
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DOI：
10.1097/js9.0000000000000249
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发表时间：
2023-05-01
期刊：
影响因子：
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接受新辅助化疗（neoCT）的胃癌（GC）患者的手术时机主要由系列放射学成像指导。然而，早期评估是必不可少的，以避免无应答者的治疗延迟和应答者的过度毒性。我们以前的研究已经确定循环细胞外囊泡来源的lncRNA-GC 1作为早期检测和监测GC进展的生物标志物。然而，neoCT的潜在作用仍然知之甚少。在这项探索性生物标志物分析中，我们进行了一项多队列研究，以检查入组RESONANCE研究（NCT 01583361）的798例患者的循环细胞外囊泡来源的lncRNA-GC 1的纵向水平。在规定的时间节点评估循环细胞外囊泡来源的lncRNA-GC 1和传统胃肠道生物标志物。在治疗前和8-10周进行计算机断层扫描（CT），并根据RECIST标准进行评估。基线时96.3%的患者可检测到循环细胞外囊泡来源的lncRNA-GC 1，在第2周期前观察到显著降低（P<0.0001）。循环细胞外囊泡来源的lncRNA-GC 1水平与肿瘤负荷的相关性更强，并且在neoCT的第一个周期中比传统的胃肠道生物标志物表现出更早的动态变化。在循环细胞外囊泡来源的lncRNA-GC 1应答（降低>50%）和放射学应答（Cohen κ，0.704）之间观察到了强一致性。重要的是，循环细胞外囊泡衍生的lncRNA-GC 1在两个外部队列中保持预测值。具有循环细胞外囊泡来源的lncRNA-GC 1应答的患者显示出上级的无病生存期[风险比（HR），0.6238; 95% CI，0.4095-0.9501; P=0.0118]和总生存期（HR，0.6131; 95% CI，0.4016-0.9358; P=0.0090）。循环细胞外囊泡来源的lncRNA-GC 1是neoCT疗效的早期标志物，可预测接受neoCT治疗的GC患者的上级生存率。
The timing of surgery for patients with gastric cancer (GC) who undergo neoadjuvant chemotherapy (neoCT) was mainly guided by serial radiologic imaging. However, an earlier assessment was indispensable to avoid delayed treatment for nonresponders and excessive toxicity for responders. Our previous study has identified circulating extracellular vesicles-derived lncRNA-GC1 as a biomarker for early detection and monitoring progression of GC. However, the potential role of neoCT remains poorly understood. In this explorative biomarker analysis, we conducted a multi-cohort study to examine longitudinal levels of circulating extracellular vesicles-derived lncRNA-GC1 in 798 patients enrolled in the RESONANCE study (NCT01583361). Both circulating extracellular vesicles-derived lncRNA-GC1 and traditional gastrointestinal biomarkers were assessed at defined time nodes. Computed tomography (CT) scans were performed before treatment and 8–10 weeks and assessed based on the RECIST criteria. Circulating extracellular vesicles-derived lncRNA-GC1 could be detected in 96.3% of patients at baseline, and significant reductions were observed before cycle 2 (P<0.0001). Levels of circulating extracellular vesicles-derived lncRNA-GC1 showed a stronger correlation with tumor burden and exhibited earlier dynamic changes than the traditional gastrointestinal biomarkers during the first cycle of neoCT. Strong agreement was observed between circulating extracellular vesicles-derived lncRNA-GC1 response (reduction >50%) and radiographic response (Cohen’s κ, 0.704). Importantly, circulating extracellular vesicles-derived lncRNA-GC1 maintained predictive value in two external cohorts. Patients with circulating extracellular vesicles-derived lncRNA-GC1 response showed superior disease-free survival [hazard ratio (HR), 0.6238; 95% CI, 0.4095–0.9501; P=0.0118] and overall survival (HR, 0.6131; 95% CI, 0.4016–0.9358; P=0.0090). Circulating extracellular vesicles-derived lncRNA-GC1 is an early marker of neoCT efficacy and predicts superior survival in GC patients treated with neoCT.
DOI：
10.4081/ejh.2020.3166
发表时间：
2020-11-10
期刊：
European journal of histochemistry : EJH
影响因子：
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作者：
Li H;Zeng Z;Yang X;Chen Y;He L;Wan T
通讯作者：
Wan T