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Article

Outcomes of Radiotherapy for Mesenchymal and Non-Mesenchymal Subtypes of Gastric Cancer

1
Departments of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
2
Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06351, Korea
3
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
4
Departments of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
5
Departments of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
6
Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul 03181, Korea
7
Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 06351, Korea
*
Authors to whom correspondence should be addressed.
Cancers 2020, 12(4), 943; https://doi.org/10.3390/cancers12040943
Received: 25 March 2020 / Revised: 4 April 2020 / Accepted: 9 April 2020 / Published: 10 April 2020
(This article belongs to the Special Issue Multimodal Therapy of Upper Gastrointestinal Malignancies)
Background: The purpose of this study was to evaluate the clinical outcomes following postoperative chemotherapy (XP) versus chemoradiotherapy (XP-RT) according to mesenchymal subtype based on RNA sequencing in gastric cancer (GC) in a cohort of the Adjuvant chemoRadioTherapy In Stomach Tumor (ARTIST) trial. Methods: Of the 458 patients enrolled in the ARTIST trial, formalin-fixed, paraffin-embedded (FFPE) specimens were available from 106 (23.1%) patients for RNA analysis. The mesenchymal subtype was classified according to a previously reported 71-gene MSS/EMT signature using the NanoString assay. Results: Of the 106 patients analyzed (50 in XP arm, 56 in XP-RT arm), 36 (34.0%) patients were categorized as mesenchymal subtype by NanoString assay. Recurrence-free survival (RFS, p = 0.009, hazard ratio (HR) = 2.11, 95% confidence interval (CI): 1.21–3.70) and overall survival (OS, p = 0.003, HR = 2.28, 95% CI: 1.31–3.96) were significantly lower in the mesenchymal subtype than in the non-mesenchymal subtype. In terms of post-operative radiotherapy (RT), mesenchymal subtype was not an independent variable to predict RFS or OS regardless to the assigned arm (XP with or without RT) in this patient cohort. However, there was a trend in the adjuvant XP arm, which showed higher OS than the XP-RT arm for the mesenchymal subtype and lower OS than the XP-RT arm for the non-mesenchymal subtype. Conclusions: We could not determine any significant differences between the mesenchymal and non-mesenchymal subtypes with respect to the effects of adjuvant XP with or without RT in gastric cancer following curative surgery. View Full-Text
Keywords: adjuvant therapy; gastrointestinal tract; genetic diagnosis; radiosensitivity adjuvant therapy; gastrointestinal tract; genetic diagnosis; radiosensitivity
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MDPI and ACS Style

Yu, J.I.; Park, H.C.; Lee, J.; Choi, C.; Kang, W.K.; Park, S.H.; Kim, S.T.; Sohn, T.S.; Lee, J.H.; An, J.Y.; Choi, M.G.; Bae, J.M.; Kim, K.-M.; Han, H.; Kim, K.; Kim, S.; Lim, D.H. Outcomes of Radiotherapy for Mesenchymal and Non-Mesenchymal Subtypes of Gastric Cancer. Cancers 2020, 12, 943. https://doi.org/10.3390/cancers12040943

AMA Style

Yu JI, Park HC, Lee J, Choi C, Kang WK, Park SH, Kim ST, Sohn TS, Lee JH, An JY, Choi MG, Bae JM, Kim K-M, Han H, Kim K, Kim S, Lim DH. Outcomes of Radiotherapy for Mesenchymal and Non-Mesenchymal Subtypes of Gastric Cancer. Cancers. 2020; 12(4):943. https://doi.org/10.3390/cancers12040943

Chicago/Turabian Style

Yu, Jeong I., Hee C. Park, Jeeyun Lee, Changhoon Choi, Won K. Kang, Se H. Park, Seung T. Kim, Tae S. Sohn, Jun H. Lee, Ji Y. An, Min G. Choi, Jae M. Bae, Kyoung-Mee Kim, Heewon Han, Kyunga Kim, Sung Kim, and Do H. Lim 2020. "Outcomes of Radiotherapy for Mesenchymal and Non-Mesenchymal Subtypes of Gastric Cancer" Cancers 12, no. 4: 943. https://doi.org/10.3390/cancers12040943

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