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. 2023 Jun 1;86(6):542-548.
doi: 10.1097/JCMA.0000000000000922. Epub 2023 Mar 29.

Immunoprofile of adenosquamous carcinoma in gastric cancer

Cheng-Han Wu  1 , Cheng-Lun Lai  1 , Chieh-Lin Jerry Teng  1   2   3   4 , Wen-Liang Fang  5   6 , Kuo-Hung Huang  5   6 , Anna Fen-Yau Li  5   7 , Hung-Yuan Yu  5   8   9 , Nai-Jung Chiang  5   10 , Yee Chao  5   10 , Yi-Ping Hung  5   10 , Ming-Huang Chen  5   10
Affiliations

Immunoprofile of adenosquamous carcinoma in gastric cancer

Cheng-Han Wu et al. J Chin Med Assoc. .

Abstract

Background: Gastric adenosquamous carcinoma (GASC) is a rare subtype of gastric cancer. Research on GASC treatment is limited, and its outcome is usually poor. We investigated the clinical features, immunoprofile of GASC, and determined the optimal treatment modality for these patients.

Methods: Patients with GASC from Taipei Veterans General Hospital were retrospectively reviewed. Clinical features and treatment outcomes were evaluated. Adequate samples were examined for surrogate biomarkers for immunotherapy by IHC staining.

Results: Total 14 (0.35%) GASC patients were found among 4034 gastric cancer patients. The median tumor size was 6.8 cm in 10 patients with stage III GASC, and all these patients underwent radical gastrectomy followed by adjuvant therapy. The median progression-free survival (PFS) and overall survival (OS) were 6.0 and 11.5 months, respectively. Two patients with stage IV GASC received frontline immunotherapy. Their median PFS and OS were 9.0 and 12.5 months. In immunoprofiling, 25.0% (n = 3), 75.0% (n = 9), and 33.3% (n = 4) of the samples had deficient mismatch repair (dMMR) protein, combined positive score (CPS) of ≥1, and CPS of ≥10, respectively. The univariate analysis revealed that programmed death-ligand 1 ≥5% (HR: 0.12; 95% CI: 0.01-0.97; p = 0.047) was significant associated with superior OS. One stage IV patient with CPS ≥10 and dMMR proteins received nivolumab monotherapy as frontline treatment that resulted 14-month PFS.

Conclusion: Patients with GASC are more likely to yield positive results for CPS and dMMR. Biomarkers should be examined, and immunotherapy can be considered as frontline systemic treatment.

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Conflict of interest statement

Conflicts of interest: Dr. Yee Chao, an editorial board member at Journal of the Chinese Medical Association , had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.

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