Abstract
Abstract Background: Gastric cancer (GC) plays a leading role in all cancer deaths especially in Eastern Asia. Current classifications including WHO, Lauren, and TCGA defined molecular classification have illuminated the clinicopathological characteristics or genetic profile of GC. However, these classifications were lack of association with clinical outcome and guidance for medication selection. Objective: We aimed to identify a new immunoclassification for GC to predict patient’s prognosis and provide evidence for choosing proper medication. Methods: Formalin-fixed and paraffin-embedded (FFPE) samples of GC were obtained along with the clinical outcome of the patient. Epstein-Barr virus (EBV) infection was measured by RT-PCR. Immune markers including CD3, CD8 and PD-L1 were measured by immunohistochemistry (IHC) at tumor infiltration area (TI) and invasive margin area (IM). The expression of PD-L1 in tumor microenvironment (TME) was assessed by immune reactive score (IRS) system. For immunoclassification, patients were classified into two subgroups: strong immunoreaction (SIR) and weak immunoreaction (WIR) defined by the number of CD8+ T cells and PD-L1 expression at TI. Results: EBV infection was associated with the number of CD3+T cells and PD-L1 expression in TME. EBV+ patients also showed a poor overall survival (OS) compared with EBV- patients. Importantly, WIR patients lived significantly shorter than SIR patients. Moreover, patients who were treated by taxanes in WIR group had a shorter OS compared with those not using taxanes. Conclusion: In this study, we suggest a new immunoclassification for gastric cancer which is associated with patients’ outcome and may provide a way to guide chemotherapy. Citation Format: Weili Wang, Ping Liao, Shangchen Xie, Dongya Shen, Chengfang Zhou, Howard Mcleod, Yijing He. Immunoclassification of gastric cancer in the context of clinical outcome [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4567. doi:10.1158/1538-7445.AM2017-4567
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