Association of Adjuvant Chemotherapy With Overall Survival Among Patients With Locally Advanced Gastric Cancer After Neoadjuvant Chemotherapy

Ji, Lin; Tang, Yi-Hui; Lin, Guan-Jie; Ma, Yu-Bin; Desiderio, Jacopo; Li, Ping; Xie, Jian‐Wei; Wang, Jia-Bin; Lü, Jun; Chen, Qi‐Yue; Cao, Long‐Long; Ma, Lin; Tu, Ru‐Hong; Zheng, Chao‐Hui; Parisi, Amilcare; Truty, Mark J.; Huang, Chang‐Ming

doi:10.1001/jamanetworkopen.2022.5557

Cited by 18 publications

(15 citation statements)

References 56 publications

(67 reference statements)

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“…Since neoadjuvant chemotherapy plays an important role in treating advanced and resectable GC patients [ 42 , 43 ], we enrolled four common chemotherapeutic drugs to assess their responsiveness between low-risk and high-risk groups through the R package “pRRophetic”. The half-maximal inhibitory concentration (IC50) of each chemotherapeutic drug in all samples showed that the risk score is positively correlated with the concentration of each drug.…”

Section: Discussionmentioning

confidence: 99%

System Analysis Based on Lipid-Metabolism-Related Genes Identifies AGT as a Novel Therapy Target for Gastric Cancer with Neoadjuvant Chemotherapy

Zhu

Zhang

et al. 2023

Pharmaceutics

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Gastric cancer (GC) is one of the most common causes of cancer-related deaths worldwide, and chemotherapy is still a standard strategy for treating patients with advanced GC. Lipid metabolism has been reported to play an important role in the carcinogenesis and development of GC. However, the potential values of lipid-metabolism-related genes (LMRGs) concerning prognostic value and the prediction of chemotherapy responsiveness in GC remains unclear. A total of 714 stomach adenocarcinoma patients were enrolled from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database. Using univariate Cox and LASSO regression analyses, we developed a risk signature based on LMRGs that can distinguish high-GC-risk patients from low-risk patients with significant differences in overall survival. We further validated this signature prognostic value using the GEO database. The R package “pRRophetic” was applied to calculate the sensitivity of each sample from high- and low-risk groups to chemotherapy drugs. The expression of two LMRGs, AGT and ENPP7, can predict the prognosis and response to chemotherapy in GC. Furthermore, AGT significantly promoted GC growth and migration, and the downregulation of AGT enhanced the chemotherapy response of GC both in vitro and in vivo. Mechanistically, AGT induced significant levels of epithelial–mesenchymal transition (EMT) through the PI3K/AKT pathway. The PI3K/AKT pathway agonist 740 Y-P can restore the EMT of GC cells impaired by AGT knockdown and treatment with 5-fluorouracil. Our findings suggest that AGT plays a key role in the development of GC, and targeting AGT may help to improve the chemotherapy response of GC patients.

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Section: Discussionmentioning

confidence: 99%

System Analysis Based on Lipid-Metabolism-Related Genes Identifies AGT as a Novel Therapy Target for Gastric Cancer with Neoadjuvant Chemotherapy

Zhu

Zhang

et al. 2023

Pharmaceutics

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“…Our study had several limitations. Being a retrospective study [ 19 , 20 ], the inherent bias (incidence-prevalence bias) cannot be excluded, and because it was a single institution, hospital-based study, generalization to the entire population would be difficult. Although the five-year survival is a standard method of representation, due to a lack of available data, we have only presented two-year survival.…”

Section: Discussionmentioning

confidence: 99%

Survival of Gastric Cancer Patients at a Tertiary Care Hospital in Eastern India: A Retrospective Data Analysis

Pradhan¹,

Agarwala²,

Sahoo³

et al. 2023

Cureus

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BackgroundGastric cancer is one of the most common cancers and a leading cause of death worldwide. Most cases of gastric cancer are diagnosed at an advanced stage when no definitive treatment is available leading to an overall declined survival rate. In this study, we aimed to investigate the survival rate of gastric cancer patients admitted to our tertiary care center and determined the relationship between sociodemographic and clinicopathological characteristics with mortality. MethodologyGastric cancer patients treated between January 2019 and December 2020 were included in this retrospective study. The clinicopathological and demographic data of 275 gastric cancer patients were analyzed. The Kaplan-Meier method was used to calculate the overall survival of gastric cancer patients. The Kaplan-Meier log-rank test was used to calculate the difference. ResultsThe mean survival of gastric cancer patients was 20.10 months (95% confidence interval = 19.20-21.03). Deaths were higher among stage III (42.6%) and stage IV (36.1%) patients compared to stage I (1.6%) and stage II (19.7%) patients. Mortality was significantly higher (70.5%) in patients without surgery. ConclusionsThe mean survival in our study setting is lower and is associated with the pathological stage of the disease, surgical intervention, and patients presenting with other gastrointestinal symptoms. A lower survival rate can be attributed to late diagnosis.

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“…The need for adjuvant therapy, especially in patients who achieve a pCR, has been widely debated. Retrospective studies in China and USA reported that patients who received adjuvant therapy after neoadjuvant treatment could gain survival benefits, especially when the lymph node ratio was above 9% and in patients who completed at least four cycles of adjuvant chemotherapy [ 44 45 ]. However, contradictions were observed in patients who achieved a pCR.…”

Section: Impacts Of Nac In Clinical Practicementioning

confidence: 99%

“…Mokdad et al [ 45 ] reported that adjuvant therapy showed favored results in even patients with ypT0 (HR, 0.63; 95% CI, 0.41–0.97) or ypN0 (HR, 0.68; 95% CI, 0.54–0.87). However, data from China did not show the survival benefit of adjuvant therapy in ypT0-1 (HR, 0.52; 95% CI, 0.04–7.07) or ypN0 (HR, 0.79; 95% CI, 0.38–1.65) subgroups [ 44 ]. It is difficult to draw conclusions based on current data; and other factors, especially the management of adverse effect and patients’ intention to undergo chemotherapy, should be considered.…”

Section: Impacts Of Nac In Clinical Practicementioning

confidence: 99%

Neoadjuvant Chemotherapy in Asian Patients With Locally Advanced Gastric Cancer

2023

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Presently, surgery is the only treatment approach for gastric cancer and improving the prognosis of locally advanced gastric cancer is one of the key factors in promoting gastric cancer survival benefit. The MAGIC study was the first to demonstrate the efficacy of neoadjuvant chemotherapy (NAC) in European countries. In recent years, several clinical trials have provided evidence for the use of NAC in Asian patients with locally advanced gastric cancer. However, clinical practice guidelines vary between Asian and non-Asian populations. Optimal NAC regimens, proper target populations, and predictors of NAC outcomes in Asian patients are still under investigation. Herein, we summarized the current progress in the administration of NAC in Asian patients with gastric cancer.

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Association of Adjuvant Chemotherapy With Overall Survival Among Patients With Locally Advanced Gastric Cancer After Neoadjuvant Chemotherapy

Cited by 18 publications

References 56 publications

System Analysis Based on Lipid-Metabolism-Related Genes Identifies AGT as a Novel Therapy Target for Gastric Cancer with Neoadjuvant Chemotherapy

System Analysis Based on Lipid-Metabolism-Related Genes Identifies AGT as a Novel Therapy Target for Gastric Cancer with Neoadjuvant Chemotherapy

Survival of Gastric Cancer Patients at a Tertiary Care Hospital in Eastern India: A Retrospective Data Analysis

Neoadjuvant Chemotherapy in Asian Patients With Locally Advanced Gastric Cancer

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