Microsatellite Instability, Epstein–Barr Virus, and Programmed Cell Death Ligand 1 as Predictive Markers for Immunotherapy in Gastric Cancer

Hung Yuan Yu, Chung Pin Li, Yi Hsiang Huang, Shao Jung Hsu, Yen Po Wang, Yun Cheng Hsieh, Wen Liang Fang, Kuo Hung Huang, Anna Fen Yau Li, Rheun Chuan Lee, Kang Lung Lee, Yuan Hung Wu, I. Chun Lai, Wan Chin Yang, Yi Ping Hung, Yu Chao Wang, Shu Hui Chen, Ming Huang Chen*, Yee Chao

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Immunotherapy benefits selected cases of gastric cancer (GC), but the correlation between biomarkers and prognosis is still unclear. Fifty-two patients with GC who underwent immunother-apy were enrolled from June 2016 to December 2020. Their clinical features and biomarkers—mi-crosatellite instability-high (MSI-H), programmed cell death ligand 1 (PD-L1) combined positive score (CPS), and Epstein–Barr encoding region (EBER)—were analyzed. Eight patients had MSI-H, five patients had EBER, 29 patients had CPS ≥ 1, and 20 patients had no biomarker. The overall response rates (ORRs) of the MSI-H, EBER, PD-L1 CPS ≥ 1, and all-negative group were 75%, 60%, 44.8%, and 15%, respectively. Compared with that of the all-negative group, progression-free survival (PFS) was better in the MSI-H (p = 0.018), CPS ≥ 5 (p = 0.012), and CPS ≥ 10 (p = 0.006) groups, but not in the EBER (p = 0.2) and CPS ≥ 1 groups (p = 0.35). Ten patients had combined biomarkers, CPS ≥ 1 with either MSI-H or EBER. The ORRs were 66.7% for CPS ≥ 1 and MSI-H and 75% for CPS ≥ 1 and EBER. PFS was better in patients with combined biomarkers (p = 0.01). MSI-H, EBER, and CPS are useful biomarkers for predicting the efficacy of immunotherapy.

Original languageEnglish
Article number218
JournalCancers
Volume14
Issue number1
DOIs
StatePublished - 1 Jan 2022

Keywords

  • Epstein–Barr virus
  • Gastric cancer
  • Immunotherapy
  • Microsatellite instability
  • Programmed cell death ligand 1

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