The Role of Human Epidermal Growth Factor Receptor (HER2/neu) in the Prognosis of Patients with Gastric Cancer

Efficacy of trastuzumab and potential risk factors on survival in patients with HER2-positive metastatic gastric cancer

Aim: To evaluate the efficacy of trastuzumab and potential risk factors on survival in patients with HER2-positive metastatic gastric cancer. Methods: We retrospectively included 138 patients who were given trastuzumab-based chemotherapy as first-line treatment and analyzed the relationship between clinical response rates and maintenance treatment status and survival outcomes. Results: In the whole group, the median progression-free survival and overall survival were 10.2 and 16 months, respectively. Clinical response was obtained in 79% of patients. The median overall survival was 16.9 months in follow-up group and 19.0 months in the maintenance group in patients with clinical response. Continuation of maintenance trastuzumab created a significant survival advantage (p = 0.021). Eastern Cooperative Oncology Group performance status 2 (hazard ratio [HR]: 2.02), grade 3 (HR: 1.78) and more than four metastatic lesions (HR: 1.67) were determined as risk factors for death. Conclusion: We recommend the continuation of maintenance trastuzumab in patients with clinical response, but those with identified risk factors may not benefit from treatment because life expectancy may be low.

A Novel Small Molecular Antibody, HER2-Nanobody, Inhibits Tumor Proliferation in HER2-Positive Breast Cancer Cells In Vitro and In Vivo

Breast cancer is the most common malignant cancer in women worldwide, especially in developing countries. Herceptin is a monoclonal antibody with an antitumor effect in HER2-positive breast cancer. However, the large molecular weight of Herceptin limited its employment. In this study, we constructed and screened HER2-nanobody and verified its tumor-suppressive effect in HER2-positive breast cancer cells. HER2-nanobody was established, filtrated, purified, and was demonstrated to inhibit cell total number, viability, colony formation and mitosis, and promote cell apoptosis in HER2-positive breast cancer cells in vitro. Treated with HER2-nanobody, tumor growth was significantly inhibited by both intratumor injection and tail intravenous injection in vivo. The phosphorylation of ERK and AKT was restrained by HER2-nanobody in HER2-positive breast cancer cells. RAS-RAF-MAPK and PI3K-AKT-mTOR are two important pathways involved in HER2. It was credible for HER2-nanobody to play the tumor suppressive role by inhibiting the phosphorylation of ERK and AKT. Therefore, HER2-nanobody could be employed as a small molecular antibody to suppress HER2-positive breast cancer.

Indications for adjuvant chemotherapy in patients with pT1N1M0 gastric cancer: a single-center experience

PURPOSE

Whether adjuvant chemotherapy (AC) has a survival benefit for all patients with pathological stage pT1N1M0 (Stage IB) gastric cancer (GC) remains controversial.

METHODS

All patients with surgically resected, histologically confirmed pT1N1M0 GC between January 2011 and December 2017 at the National Cancer Center, China, were retrospectively reviewed.

RESULTS

A total of 179 patients with pT1N1M0 were identified. Survival analysis showed that both overall survival (OS) and cause-specific survival (CSS) were significantly different between patients treated with and without AC (p < 0.01). Independent risk factors for reduced OS identified in the Cox regression analysis in patients with pT1N1M0 cancer were sex (male sex, hazard ratio [HR] 2.470, 95% confidence interval [CI] 1.294-4.718), examined lymph nodes (EN) (EN ≤ 15, HR 2.402; 95% CI 1.329-4.341), and AC (treated without AC, HR 2.554; 95% CI 1.393-4.681), which were also independent risk factors for reduced CSS. We divided patients with pT1N1M0 into three risk categories (high, moderate, and low) according to two significant prognostic factors (sex and EN) and found that both OS and CSS were significantly different between the three risk groups (p < 0.05).

CONCLUSION

An additional survival benefit related to AC is expected for selected pT1N1M0 patients. Male patients with EN ≤ 15 may be particularly appropriate candidates for AC.

Identification of kinesin family member 3B (KIF3B) as a molecular target for gastric cancer

Gastric cancer (GC) is the fourth most common malignancy worldwide, with 80% mortality rate in over 70% countries. Recently, targeted therapy for GC has great clinical prospects, and it is still badly needed to find novel molecular targets to control the progression and development of GC. Kinesin family member 3B (KIF3B) is known as a microtubule motor kinesin and one of the most ubiquitously expressed KIFs. KIF3B participates in multiple cellular processes such as mitosis and spermatogenesis, and the possible role of KIF3B on tumor progression has been widely revealed. KIF3B affects the progression and metastasis of multiple types of tumors, such as pancreatic cancer, prostate cancer, and hepatocellular carcinoma; however, its potential impact on GC is still unknown. Herein, we explored the possible role of KIF3B on the progression of GC and noticed that KIF3B was high expression in tumor tissues from GC patients. KIF3B was also significantly correlated with clinical pathological characteristics such as tumor size (P = .014*) and recurrence (P = .044*). We further revealed that KIF3B depleted GC cells exhibited impaired proliferation capacity in vitro. Similarly, KIF3B depletion suppressed tumor growth of GC cells in mice. In conclusion, we identified KIF3B as a promising therapeutic target for the treatment of GC.