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Review
. 2021 Sep 1:13:17588359211029559.
doi: 10.1177/17588359211029559. eCollection 2021.

Biomarker evaluation in radically resectable locally advanced gastric cancer treated with neoadjuvant chemotherapy: an evidence reappraisal

Lorenzo Gervaso  1 , Stefania Pellicori  1 , Chiara A Cella  1 , Vincenzo Bagnardi  2 , Florian Lordick  3 , Nicola Fazio  4
Affiliations
Review

Biomarker evaluation in radically resectable locally advanced gastric cancer treated with neoadjuvant chemotherapy: an evidence reappraisal

Lorenzo Gervaso et al. Ther Adv Med Oncol. .

Abstract

Neoadjuvant chemotherapy (NAC) significantly improved the prognosis of patients with locally advanced resectable gastric cancer but, despite important progresses, relapse-related death remains a major challenge. Therefore, it appears crucial to understand which patients will benefit from peri-operative treatment. Biomarkers such as human epidermal growth factor receptor-2 (HER2), microsatellite instability (MSI), and Epstein-Barr Virus (EBV) have been widely studied; however, they do not yet guide the choice of perioperative treatment in clinical practice. We performed a narrative review, including 23 studies, addressing the value of tissue- or blood-based biomarkers in the neoadjuvant setting. Ten studies (43.5%) were prospective, and more than half were conducted in East-Asia. Biomarkers were evaluated only post-NAC (on surgical samples or blood) in seven studies (30.4%), only pre-NAC (on endoscopic specimens or blood) in 10 studies (43.5%), and both pre- and post-NAC (26.1%) in six studies. Among the high variety of investigated biomarkers, some of these including MSI-H or enzymatic profile (as TS, UGT1A1, MTHFR, ERCC or XRCC) showed promising results and deserve to be assessed in methodologically sound clinical trials. The identification of molecular biomarkers in patients treated with NAC for locally advanced resectable gastric or EGJ cancer remains crucial.

Keywords: biomarkers; gastric cancer; neoadjuvant chemotherapy; predictive factors; prognostic factors.

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Conflict of interest statement

Conflict of interest statement: FLorian Lordick declares COI for: Amgen Advisory Board Astellas Advisory Board Astra Zeneca Invited Speaker Bayer Advisory Board Beigene Advisory Board Biontech Expert Testimony BMS Invited Speaker BMS Advisory Board BMS Expert Testimony Eli Lilly Invited Speaker Eli Lilly Advisory Board Elsevier Expert Testimony Iomedico Writing Engagement Medscape Invited Speaker MedUpdate Invited Speaker Merck Serono Invited Speaker MSD Invited Speaker MSD Advisory Board MSD Expert Testimony Roche Invited Speaker Roche Advisory Board Promedicis Invited Speaker Servier Invited Speaker Servier Advisory Board Springer-Nature Writing Engagement StreamedUp! Invited Speaker Zymeworks Advisory Board Imedex Invited Speaker Deutscher Ärzteverlag Writing Engagement Nicola Fazio declares COI for Novartis Consulting and advisory services, speaking engagements, Steering committee Ipsen Consulting and advisory services, speaking engagements, Steering committee Pfizer Advisory services Merck Serono Advisory services, Speaking engagements Advanced Accelerator Applications Advisory services MSD Advisory services Sanofi-Aventis Speaking engagements ACCMED Speaking engagements Wren Laboratories Europe Advisory services EANM Advisory services Springer Writing engagements Pensiero Scientifico EditoreWriting engagements All other authors declare no COIs.

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References

    1. Cunningham D, Allum WH, Stennin SP, et al.. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006; 355: 11–20. - PubMed
    1. Ychou M, Boige V, Pignon J-P, et al.. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol 2011; 29: 1715–1721. - PubMed
    1. Al-Batran SE, Homann N, Pauligk C, et al.. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet 2019; 393: 1948–1957. - PubMed
    1. Fazio N, Biffi R, Maibach R, et al.. Preoperative versus postoperative docetaxel-cisplatin-fluorouracil (TCF) chemotherapy in locally advanced resectable gastric carcinoma: 10-year follow-up of the SAKK 43/99 phase III trial. Ann Oncol 2016; 27: 668–673. - PubMed
    1. Cancer Genome Atlas Research Network. Comprehensive molecular characterization of gastric adenocarcinoma. Nature 2014; 513: 202–209. - PMC - PubMed