Zhang Zhening, Yu Yiyi, Xie Tong, Qi Changsong, Zhang Xiaotian, Shen Lin, Peng Zhi
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
Fudan Zhongshan Cancer Center, Zhongshan Hospital Fudan University, Shanghai, China.
Cancer Med. 2023 Oct;12(19):19583-19594. doi: 10.1002/cam4.6575. Epub 2023 Sep 29.
The clinicopathological features of MET-amplified gastric cancer (GC) and real-world data on the efficacy of MET-targeted therapies remain unknown. Pulmonary lymphangitis carcinomatosis (PLC) is a peculiar manifestation of GC, whose management has not been thoroughly described.
This study analyzed patients diagnosed with MET-amplified GC or GC with PLC at any time point of the disease course from 2011 to 2021 in two centers. Clinicopathological features and survival outcomes of MET-amplified GC were analyzed. The clinical and molecular implications of GC with PLC were discussed.
Fifty-eight patients with MET-amplified GC and 20 patients with GC accompanied by PLC were finally enrolled for analysis (including 13 overlapped patients). GC with PLC was more common in female patients (p = 0.010), diagnosed at a younger age (p = 0.002), presented with a higher baseline ECOG PS (p = 0.016), and was more likely to develop lung metastasis (p < 0.001), and serous effusion (p = 0.026) than GC without PLC. Patients with primary MET-amplified GC had a worse prognosis than those with secondary MET-amplified GC (p = 0.005). The application of anti-MET therapy was associated with numerically prolonged survival, but the association was not statistically significant (p = 0.07). MET amplification was concentrated in patients with PLC, in which anti-MET therapies elicited a high response rate.
MET-targeted therapies are efficacious in real-world populations with MET-amplified GC. Patients with PLC have distinct clinical and molecular features and might benefit from MET-targeted therapies.
MET扩增型胃癌（GC）的临床病理特征以及MET靶向治疗疗效的真实世界数据仍不清楚。肺淋巴管癌病（PLC）是GC的一种特殊表现，其治疗方法尚未得到充分描述。
本研究分析了2011年至2021年期间在两个中心疾病过程中任何时间点被诊断为MET扩增型GC或GC伴PLC的患者。分析了MET扩增型GC的临床病理特征和生存结果。讨论了GC伴PLC的临床和分子意义。
最终纳入58例MET扩增型GC患者和20例GC伴PLC患者进行分析（包括13例重叠患者）。与无PLC的GC相比，GC伴PLC在女性患者中更常见（p = 0.010），诊断时年龄更小（p = 0.002），基线ECOG PS更高（p = 0.016），更易发生肺转移（p < 0.001）和浆液性胸腔积液（p = 0.026）。原发性MET扩增型GC患者的预后比继发性MET扩增型GC患者更差（p = 0.005）。抗MET治疗的应用与生存时间的延长在数值上相关，但该关联无统计学意义（p = 0.07）。MET扩增集中在PLC患者中，其中抗MET治疗引发了较高的缓解率。
MET靶向治疗在MET扩增型GC的真实世界人群中有效。PLC患者具有独特的临床和分子特征，可能从MET靶向治疗中获益。
