Association of genomic characterization with clinical benefits of anti-PD-1 antibody combined with FOLFOX as neoadjuvant therapy on locally advanced gastric or gastroesophageal junction adenocarcinoma.

Authors

null

Ying Liu

Department of Medical Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China

Ying Liu , Guangsen Han , Hongle Li , Yuzhou Zhao , Zhi Li , Zhentian Liu , Jing Zhuang , Gangcheng Wang , Baodong Li , Jinbang Wang , Zhimeng Li , Qingxin Xia , Chengjuan Zhang , Juan Yu , Xuan Gao , Ke Li , Shuning Xu , Lei Qiao , Gaizhen Kuang , Danyang Li

Organizations

Department of Medical Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China, Department of Surgical Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China, Department of Molecular Pathology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China, Geneplus-Beijing, Geneplus-Beijing institute, Beijing, China, Department of Pathology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China, Department of Endoscopy Center, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China

Research Funding

No funding received
None

Background: Anti-PD-1 antibody combined with chemotherapy showed promising efficacy in gastric adenocarcinoma. However, little is known about biomarkers that identify clinical response. Here, we focus on genomic alteration patterns to predict response of neoadjuvant immunotherapy in patients with locally advanced gastric or gastroesophageal junction adenocarcinoma (GC/GEJC). Methods: Patients with locally advanced GC/GEJC were received 4 cycles of FOLFOX plus anti-PD-1 antibody (camrelizumab) as neoadjuvant therapy in the study. We prospectively conducted whole exome sequencing (WES) in paired biopsy specimens from enrolled patients at baseline. According to Tumor Regression Grading (TRG) assessment by postoperative pathology, patients were classified into group A (TRG0 & TRG1) and group B (TRG2 & TRG3). Results: We eventually performed WES in 23 patients who had adequate available tumor tissues. The clinical characterizations were not significantly different between two groups. All 23 cases were microsatellite stable (MSS). Alterations of AHNAK2 (50.0%/6.67%), TG (50.0%/6.67%), CTNNB1 (37.5%/0.0%) and ZFHX2 (37.5%/0.0%) significantly enriched in group A (n = 8) compared to group B (n = 15).Furthermore, we inspecting 10 hallmark oncogenic pathways, alterations of WNT pathway also occurred more frequently in group A than those of group B. Genomic alterations in WNT pathway were identified in 5 of 23 cases (21.74%), of which the most frequently mutated genes were CTNNB1 (13.04%), LRP5 (8.69%) and RNF43 (8.69%). Tumor mutation burden (TMB, p = 0.357), whole genome duplication (WGD) status (p = 0.667), copy number variant burden (p = 0.825), fraction of loss of heterozygosity (LOH) in chromosome level (p: 0.07-1), tumor neoantigen burden (TNB) (p = 0.65), HLA type (p: 0.49-1) and HLA LOH status (p: 0.37-1) were not significantly associated with neoadjuvant therapy response. Conclusions: Aberrant activation of WNT pathway was reported to be associated with immune evasion. Our study demonstrated that CTNNB1/WNT-pathway-mut may be a promising predictor for clinical response of neoadjuvant immutherapy in GC/GEJC. Clinical trial information: NCT03939962

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Esophageal or Gastric Cancer

Clinical Trial Registration Number

NCT03939962

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr e16025)

DOI

10.1200/JCO.2021.39.15_suppl.e16025

Abstract #

e16025

Abstract Disclosures