Mutational spectrum for guiding the decision of adjuvant treatment in patients with resected biliary tract carcinoma
Background Systemic chemotherapy or chemoradiation therapy has proven to be effective in treating advanced biliary tract carcinoma (BTC). However, its efficacy in the adjuvant setting remains controversial. Therefore, this study aimed to determine the prognostic significance of genomic biomarkers in...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Language: | English |
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Wiley
2023-08-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6261 |
| _version_ | 1797361189941936128 |
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| author | Yunfeng Li Chaochao Tan Xinmin Yin Siwei Zhu Rongyao Cai Chunhong Liao Yifei Wu Qihong Zeng Chengzhi Cai Wang Xie Xiangyu He Hao‐quan Wen Guomin Lin Qingqing He Tingting He Peng Gu Chang‐jun Liu |
| author_facet | Yunfeng Li Chaochao Tan Xinmin Yin Siwei Zhu Rongyao Cai Chunhong Liao Yifei Wu Qihong Zeng Chengzhi Cai Wang Xie Xiangyu He Hao‐quan Wen Guomin Lin Qingqing He Tingting He Peng Gu Chang‐jun Liu |
| author_sort | Yunfeng Li |
| collection | DOAJ |
| description | Background Systemic chemotherapy or chemoradiation therapy has proven to be effective in treating advanced biliary tract carcinoma (BTC). However, its efficacy in the adjuvant setting remains controversial. Therefore, this study aimed to determine the prognostic significance of genomic biomarkers in resected BTC and their potential role in stratifying patients for adjuvant treatment. Methods We retrospectively reviewed 113 BTC patients who underwent curative‐intent surgery and had available tumor sequencing data. Disease‐free survival (DFS) was the primary outcome examined and univariate analysis was used to identify gene mutations with prognostic value. Favorable and unfavoratble gene subsets were distinguished from the selected genes through grouping, respectively. Multivariate Cox regression was used to identify independent prognostic factors of DFS. Results Our results indicated that mutations in ACVR1B, AR, CTNNB1, ERBB3, and LRP2 were favorable mutations, while mutations in ARID1A, CDKN2A, FGFR2, NF1, NF2, PBRM1, PIK3CA, and TGFBR1 were unfavorable mutations. In addition to age, sex, and node positive, favorable genes (HR = 0.15, 95% CI = 0.04–0.48, p = 0.001) and unfavorable genes (HR = 2.86, 95% CI = 1.51–5.29, p = 0.001) were identified as independent prognostic factors for DFS. Out of the 113 patients, only 35 received adjuvant treatment whereas the majority (78) did not. For patients with both favorable and unfavorable mutations undetected, adjuvant treatment showed negative effect on DFS (median DFS: S441 vs. 956 days, p = 0.010), but there was no significant difference in DFS among those in other mutational subgroups. Conclusions Genomic testing might be useful in guiding the decisions regarding adjuvant treatment in BTC. |
| first_indexed | 2024-03-08T15:50:22Z |
| format | Article |
| id | doaj.art-0e44734003ad4b1ea76e910a4c974701 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-08T15:50:22Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-0e44734003ad4b1ea76e910a4c9747012024-01-09T05:41:08ZengWileyCancer Medicine2045-76342023-08-011215160761608610.1002/cam4.6261Mutational spectrum for guiding the decision of adjuvant treatment in patients with resected biliary tract carcinomaYunfeng Li0Chaochao Tan1Xinmin Yin2Siwei Zhu3Rongyao Cai4Chunhong Liao5Yifei Wu6Qihong Zeng7Chengzhi Cai8Wang Xie9Xiangyu He10Hao‐quan Wen11Guomin Lin12Qingqing He13Tingting He14Peng Gu15Chang‐jun Liu16Department of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Clinical Medical Laboratory Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaShanghai OrigiMed Co., Ltd. Shanghai ChinaShanghai OrigiMed Co., Ltd. Shanghai ChinaShanghai OrigiMed Co., Ltd. Shanghai ChinaShanghai OrigiMed Co., Ltd. Shanghai ChinaDepartment of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha ChinaBackground Systemic chemotherapy or chemoradiation therapy has proven to be effective in treating advanced biliary tract carcinoma (BTC). However, its efficacy in the adjuvant setting remains controversial. Therefore, this study aimed to determine the prognostic significance of genomic biomarkers in resected BTC and their potential role in stratifying patients for adjuvant treatment. Methods We retrospectively reviewed 113 BTC patients who underwent curative‐intent surgery and had available tumor sequencing data. Disease‐free survival (DFS) was the primary outcome examined and univariate analysis was used to identify gene mutations with prognostic value. Favorable and unfavoratble gene subsets were distinguished from the selected genes through grouping, respectively. Multivariate Cox regression was used to identify independent prognostic factors of DFS. Results Our results indicated that mutations in ACVR1B, AR, CTNNB1, ERBB3, and LRP2 were favorable mutations, while mutations in ARID1A, CDKN2A, FGFR2, NF1, NF2, PBRM1, PIK3CA, and TGFBR1 were unfavorable mutations. In addition to age, sex, and node positive, favorable genes (HR = 0.15, 95% CI = 0.04–0.48, p = 0.001) and unfavorable genes (HR = 2.86, 95% CI = 1.51–5.29, p = 0.001) were identified as independent prognostic factors for DFS. Out of the 113 patients, only 35 received adjuvant treatment whereas the majority (78) did not. For patients with both favorable and unfavorable mutations undetected, adjuvant treatment showed negative effect on DFS (median DFS: S441 vs. 956 days, p = 0.010), but there was no significant difference in DFS among those in other mutational subgroups. Conclusions Genomic testing might be useful in guiding the decisions regarding adjuvant treatment in BTC.https://doi.org/10.1002/cam4.6261adjuvant therapybile duct cancercholangiocarcinomagallbladder cancernext‐generation sequencing |
| spellingShingle | Yunfeng Li Chaochao Tan Xinmin Yin Siwei Zhu Rongyao Cai Chunhong Liao Yifei Wu Qihong Zeng Chengzhi Cai Wang Xie Xiangyu He Hao‐quan Wen Guomin Lin Qingqing He Tingting He Peng Gu Chang‐jun Liu Mutational spectrum for guiding the decision of adjuvant treatment in patients with resected biliary tract carcinoma Cancer Medicine adjuvant therapy bile duct cancer cholangiocarcinoma gallbladder cancer next‐generation sequencing |
| title | Mutational spectrum for guiding the decision of adjuvant treatment in patients with resected biliary tract carcinoma |
| title_full | Mutational spectrum for guiding the decision of adjuvant treatment in patients with resected biliary tract carcinoma |
| title_fullStr | Mutational spectrum for guiding the decision of adjuvant treatment in patients with resected biliary tract carcinoma |
| title_full_unstemmed | Mutational spectrum for guiding the decision of adjuvant treatment in patients with resected biliary tract carcinoma |
| title_short | Mutational spectrum for guiding the decision of adjuvant treatment in patients with resected biliary tract carcinoma |
| title_sort | mutational spectrum for guiding the decision of adjuvant treatment in patients with resected biliary tract carcinoma |
| topic | adjuvant therapy bile duct cancer cholangiocarcinoma gallbladder cancer next‐generation sequencing |
| url | https://doi.org/10.1002/cam4.6261 |
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