Characteristics and response to next‐generation sequencing‐guided therapy in locally advanced or metastatic esophageal cancer. Issue 3 (13th October 2022)

• Record Type: Journal Article
• Authors: Ma, Yueyun; Li, Wenjie; Chen, Shiyu; Lin, Shuimiao; Ding, Sijie; Zhou, Xiaomei; Liu, Tongxin; Wang, Rong; Wang, Wei
• Is Part Of: International journal of cancer. Volume 152:Issue 3(2023)
• Page Start: 436
• Page End: 446
• Publication Date: 2022-10-13
• Subjects: clinical benefit -- esophageal cancer -- mutation landscape -- next‐generation sequencing; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.34315
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: Esophageal cancer (EC) is a main cause of cancer‐related deaths. However, genomic alterations and the clinical value of next‐generation sequencing (NGS) in advanced or metastatic EC for precision therapy remain largely unclear. Herein, we performed comprehensive analyses on a cohort of 47 individuals with advanced or metastatic EC who underwent NGS between May 2017 and February 2020. Eventually, 227 mutated genes were identified in the cohort. TP53, NQO1, DPYD, GSTM1, XRCC1 and ERCC1 were the most mutated genes and associated with immune cell infiltration, autophagy and hypoxia. Patients who received NGS‐guided treatments exhibited better objective remission rate (ORR) (72.22%), disease control rate (DCR) (88.89%), overall survival (OS) ( P = .0019) and progression‐free survival (PFS) ( P = .0077) than those not receiving NGS‐guided therapies. The multivariate analyses further demonstrated that the NGS‐guided therapy was an independently prognostic factor (OS: hazard radio [HR] 0.31, 95% coincidence interval [CI] 0.1‐0.97, P = .04). In conclusion, we depicted a comprehensive mutational landscape of 47 patients with locally advanced or metastatic EC and illustrated the utility of NGS testing to guide clinical management in improving ORR, DCR, OS and PFS. Abstract : What's new? The genomic alterations in advanced or metastatic esophageal cancer and the clinical value of next‐generation sequencing for precision therapy remain largely unknown. Here, the authors depict the comprehensive mutational landscape of 47 patients with locally‐advanced or metastatic esophageal cancer, identifying TP53, NQO1, DPYD, GSTM1, XRCC1 and ERCC1 as the most common mutated genes. Patients who received next‐generation sequencing‐guided therapies based on their mutational profile showed better remission and disease control rates and improved survival. The results suggest that next‐generation sequencing could shift the paradigm from existing organ‐specific regimens to tailored gene‐targeting treatments in esophageal cancer.