Characteristics and response to next-generation sequencing-guided therapy in locally advanced or metastatic esophageal cancer

Int J Cancer. 2023 Feb 1;152(3):436-446. doi: 10.1002/ijc.34315. Epub 2022 Oct 13.

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.

Keywords: clinical benefit; esophageal cancer; mutation landscape; next-generation sequencing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Esophageal Neoplasms* / genetics
  • Esophageal Neoplasms* / therapy
  • Genomics
  • High-Throughput Nucleotide Sequencing*
  • Humans
  • Mutation
  • Progression-Free Survival
  • X-ray Repair Cross Complementing Protein 1 / genetics

Substances

  • XRCC1 protein, human
  • X-ray Repair Cross Complementing Protein 1