Nakamura Naohiko, Kaida Daisuke, Tomita Yasuto, Miyata Takashi, Miyashita Tomoharu, Fujita Hideto, Kinami Shinichi, Ueda Nobuhiko, Takamura Hiroyuki
Department of Surgical Oncology, Kanazawa Medical University Hospital, Ishikawa, Japan.
Cancer Diagn Progn. 2022 May 3;2(3):293-299. doi: 10.21873/cdp.10107. eCollection 2022 May-Jun.
BACKGROUND/AIM: This study aimed to evaluate the relationship between clinical outcomes and intra-tumoral fibroblast growth factor receptor 2 (FGFR2) expression in human epidermal growth factor receptor 2 (HER2)-positive gastric cancer (GC) patients who had undergone HER2-targeted chemotherapy.
A retrospective analysis was performed in 22 patients with HER2-positive GC, who had undergone systemic chemotherapy. We performed immunohistochemistry staining of FGFR2 expression using surgically resected specimens or biopsied samples and evaluated clinicopathological characteristic and overall survival (OS) in the FGFR2-negative and -positive GC groups.
A total of 8 and 14 patients were placed in the FGFR2-negative and -positive group, respectively. The median OS rates were 56.2 and 16.0 months in the FGFR2-negative and -positive groups, respectively. The FGFR2-negative group had a significantly better prognosis after HER2-targeted chemotherapy [p=0.027 (log-rank test)]. The univariate analysis revealed that performing gastrectomy, response to combination chemotherapy with trastuzumab, and FGFR2 positivity were significantly correlated with OS. In a multivariate analysis, the response to combination chemotherapy with trastuzumab (p=0.008) was significantly correlated with OS. In addition, the proportions of patients who showed CR or PR in response to chemotherapy were 87.5 and 42.9% in the FGFR2-negative and -positive groups, respectively (p=0.031).
HER2-positive GC patients, without overexpression of FGFR2, exhibited an improved prognosis and response rate to trastuzumab combination chemotherapy. Assessment of intra-tumoral FGFR2 expression could be helpful in predicting the prognosis and response to trastuzumab in HER2-positive GC patients.
背景/目的：本研究旨在评估接受人表皮生长因子受体2（HER2）靶向化疗的HER2阳性胃癌（GC）患者的临床结局与肿瘤内成纤维细胞生长因子受体2（FGFR2）表达之间的关系。
对22例接受全身化疗的HER2阳性GC患者进行回顾性分析。我们使用手术切除标本或活检样本对FGFR2表达进行免疫组织化学染色，并评估FGFR2阴性和阳性GC组的临床病理特征及总生存期（OS）。
分别有8例和14例患者被纳入FGFR2阴性和阳性组。FGFR2阴性和阳性组的中位OS率分别为56.2个月和16.0个月。HER2靶向化疗后，FGFR2阴性组的预后明显更好[p = 0.027（对数秩检验）]。单因素分析显示，行胃切除术、对曲妥珠单抗联合化疗的反应以及FGFR2阳性与OS显著相关。多因素分析中，对曲妥珠单抗联合化疗的反应（p = 0.008）与OS显著相关。此外，FGFR2阴性和阳性组中化疗后达到完全缓解（CR）或部分缓解（PR）的患者比例分别为87.5%和42.9%（p = 0.031）。
未过表达FGFR2的HER2阳性GC患者，其预后及对曲妥珠单抗联合化疗的反应率有所改善。评估肿瘤内FGFR2表达可能有助于预测HER2阳性GC患者的预后及对曲妥珠单抗的反应。
