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Single Patient Classifier Assay, Microsatellite Instability, and Epstein-Barr Virus Status Predict Clinical Outcomes in Stage II/III Gastric Cancer: Results from CLASSIC Trial

Authors
 Chul Kyu Roh  ;  Yoon Young Choi  ;  Seohee Choi  ;  Won Jun Seo  ;  Minah Cho  ;  Eunji Jang  ;  Taeil Son  ;  Hyoung-Il Kim  ;  Hyeseon Kim  ;  Woo Jin Hyung  ;  Yong-Min Huh  ;  Sung Hoon Noh  ;  Jae-Ho Cheong 
Citation
 Yonsei Medical Journal, Vol.60(2) : 132-139, 2019 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2019
Keywords
EBV ;  Gastric cancer ;  microsatellite instability ;  single patient classifier
Abstract
Clinical implications of single patient classifier (SPC) and microsatellite instability (MSI) in stage II/III gastric cancer have been reported. We investigated SPC and the status of MSI and Epstein-Barr virus (EBV) as combinatory biomarkers to predict the prognosis and responsiveness of adjuvant chemotherapy for stage II/III gastric cancer. MATERIALS AND METHODS: Tumor specimens and clinical information were collected from patients enrolled in CLASSIC trial, a randomized controlled study of capecitabine plus oxaliplatin-based adjuvant chemotherapy. The results of nine-gene based SPC assay were classified as prognostication (SPC-prognosis) and prediction of chemotherapy benefit (SPC-prediction). Five quasimonomorphic mononucleotide markers were used to assess tumor MSI status. EBV-encoded small RNA in situ hybridization was performed to define EBV status. RESULTS: There were positive associations among SPC, MSI, and EBV statuses among 586 patients. In multivariate analysis of disease-free survival, SPC-prognosis [hazard ratio (HR): 1.879 (1.101-3.205), 2.399 (1.415-4.067), p=0.003] and MSI status (HR: 0.363, 95% confidence interval: 0.161-0.820, p=0.015) were independent prognostic factors along with age, Lauren classification, TNM stage, and chemotherapy. Patient survival of SPC-prognosis was well stratified regardless of EBV status and in microsatellite stable (MSS) group, but not in MSI-high group. Significant survival benefit from adjuvant chemotherapy was observed by SPC-Prediction in MSS and EBV-negative gastric cancer. CONCLUSION: SPC, MSI, and EBV statuses could be used in combination to predict the prognosis and responsiveness of adjuvant chemotherapy for stage II/III gastric cancer. © Copyright: Yonsei University College of Medicine 2019.
Files in This Item:
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DOI
10.3349/ymj.2019.60.2.132
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Son, Tae Il(손태일) ORCID logo https://orcid.org/0000-0002-0327-5224
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Cho, Minah(조민아) ORCID logo https://orcid.org/0000-0003-3011-5813
Choi, Seo Hee(최서희)
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
Huh, Yong Min(허용민) ORCID logo https://orcid.org/0000-0002-9831-4475
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170271
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