• J Chin Med Assoc · Jun 2023

    Immunoprofile of adenosquamous carcinoma in gastric cancer.

    • Cheng-Han Wu, Cheng-Lun Lai, Chieh-Lin Jerry Teng, Wen-Liang Fang, Kuo-Hung Huang, Fen-Yau LiAnnaASchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.Department of Pathology, Cheng Hsin General Hospital, Taipei, Taiwan, ROC., Hung-Yuan Yu, Nai-Jung Chiang, Yee Chao, Yi-Ping Hung, and Ming-Huang Chen.
    • Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
    • J Chin Med Assoc. 2023 Jun 1; 86 (6): 542548542-548.

    BackgroundGastric adenosquamous carcinoma (GASC) is a rare subtype of gastric cancer. Research on GASC treatment is limited, and its outcome is usually poor. We investigated the clinical features, immunoprofile of GASC, and determined the optimal treatment modality for these patients.MethodsPatients with GASC from Taipei Veterans General Hospital were retrospectively reviewed. Clinical features and treatment outcomes were evaluated. Adequate samples were examined for surrogate biomarkers for immunotherapy by IHC staining.ResultsTotal 14 (0.35%) GASC patients were found among 4034 gastric cancer patients. The median tumor size was 6.8 cm in 10 patients with stage III GASC, and all these patients underwent radical gastrectomy followed by adjuvant therapy. The median progression-free survival (PFS) and overall survival (OS) were 6.0 and 11.5 months, respectively. Two patients with stage IV GASC received frontline immunotherapy. Their median PFS and OS were 9.0 and 12.5 months. In immunoprofiling, 25.0% (n = 3), 75.0% (n = 9), and 33.3% (n = 4) of the samples had deficient mismatch repair (dMMR) protein, combined positive score (CPS) of ≥1, and CPS of ≥10, respectively. The univariate analysis revealed that programmed death-ligand 1 ≥5% (HR: 0.12; 95% CI: 0.01-0.97; p = 0.047) was significant associated with superior OS. One stage IV patient with CPS ≥10 and dMMR proteins received nivolumab monotherapy as frontline treatment that resulted 14-month PFS.ConclusionPatients with GASC are more likely to yield positive results for CPS and dMMR. Biomarkers should be examined, and immunotherapy can be considered as frontline systemic treatment.Copyright © 2023, the Chinese Medical Association.

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