Clinical significance of circulating tumor cells in the response to trastuzumab for HER2-negative metastatic gastric cancer
Clinical significance of circulating tumor cells in the response to trastuzumab for HER2-negative metastatic gastric cancer
复制标题
DOI：
10.1007/s00280-021-04251-z
复制
发表时间：
2021-02
影响因子：
3
通讯作者：
Daisuke Matsushita;Y. Uenosono;T. Arigami;Shigehiro Yanagita;K. Okubo;T. Kijima;F. Miyazono;M. Hamanoue;S. Hokita;S. Nakashima;T. Ohtsuka;S. Natsugoe
中科院分区：
文献类型：
--
作者：
Daisuke Matsushita;Y. Uenosono;T. Arigami;Shigehiro Yanagita;K. Okubo;T. Kijima;F. Miyazono;M. Hamanoue;S. Hokita;S. Nakashima;T. Ohtsuka;S. Natsugoe
目的曲妥珠单抗治疗HER2阳性的转移性胃癌患者，改善其预后。循环肿瘤细胞（CTC）已被视为胃癌的预后预测因子。曲妥珠单抗的临床优势进行了检查，在胃癌患者与HER2阴性肿瘤组织和HER2阳性CTCs.MethodsA共105例转移或复发性胃癌患者入组。采用CellSearch系统检测所有患者外周血CTC中HER2的表达。61.9%，61例患者分为3组：A组（n= 27），组织学HER2阳性，B组（n= 17），组织学HER2阴性和HER2阳性CTC，C组（n= 17），组织学和CTC均为HER2阴性。患者接受卡培他滨联合顺铂治疗。A、B组在此基础上加用曲妥珠单抗治疗，肿瘤组织中HER2的表达与CTCs之间无相关性。即使B组无组织学HER2表达，B组的预后与A组相同，C组的总生存率明显低于A组和B组。多变量分析表明，HER2表达CTCs是一个独立的预后因素，为整体和无进展survival.ConclusionThe目前的结果表明，潜在的临床效用曲妥珠单抗联合化疗的患者HER2阳性的CTCs，即使他们是组织学HER2阴性。
PurposeThe prognosis of metastatic gastric cancer has improved due to trastuzumab in patients with HER2 positive. Circulating tumor cells (CTCs) have been examined as a prognostic predictor in gastric cancer. The clinical advantage of trastuzumab was examined in gastric cancer patients with HER2-negative tumor tissues and HER2-positive CTCs.MethodsA total of 105 patients with metastatic or recurrence gastric cancer were enrolled. All patients were examined HER2 expression in CTC using the CellSearch system in blood specimens.ResultsCTCs were detected in 65 of 105 patients (61.9%) and 61 patients were divided into three groups: Group A (n= 27), histological HER2-positive; Group B (n= 17), histological HER2-negative and HER2-positive CTCs; and Group C (n= 17), HER2-negative on histology and CTCs. Patients received capecitabine plus cisplatin. Groups A and B were additionally treated by trastuzumab.There was no relationship between tumor tissues and CTCs in HER2 expression. Even if group B had no histological HER2 expression, group B showed a good prognosis as same as group A, and group C had a significantly worse overall survival than groups A and B. The multivariate analysis demonstrated that HER2-expression on CTCs was an independent prognostic factor for both overall and progression-free survival.ConclusionThe present results indicate the potential clinical utility of trastuzumab combined chemotherapy in patients with HER2-positive CTCs even if they are histologically HER2-negative.