GASC1-Adapted Neoadjuvant Chemotherapy for Resectable Esophageal Squamous Cell Carcinoma: A Prospective Clinical Biomarker Trial

Ruinuo Jia; Youjia Mi; Xiang Yuan; Dejiu Kong; Wanying Li; Ruonan Li; Bingbing Wang; Yafei Zhu; Jinyu Kong; Zhikun Ma; Na Li; Qiangjian Mi; Shegan Gao

doi:10.1155/2020/1607860

GASC1-Adapted Neoadjuvant Chemotherapy for Resectable Esophageal Squamous Cell Carcinoma: A Prospective Clinical Biomarker Trial

J Oncol. 2020 Jan 30:2020:1607860. doi: 10.1155/2020/1607860. eCollection 2020.

Authors

Ruinuo Jia^{1

2}, Youjia Mi¹, Xiang Yuan¹, Dejiu Kong¹, Wanying Li¹, Ruonan Li¹, Bingbing Wang¹, Yafei Zhu¹, Jinyu Kong¹, Zhikun Ma^{1

3}, Na Li¹, Qiangjian Mi¹, Shegan Gao^{1

2}

Affiliations

¹ Cancer Hospital, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan 471000, China.
² College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan 471000, China.
³ Julius L. Chambers Biomedical/Biotechnology Research Institute, Department of Biological and Biomedical Sciences, North Carolina Central University, Kannapolis, NC 28081, USA.

Abstract

Neoadjuvant chemotherapy (NCT) is a standard care for esophageal squamous cell carcinoma (ESCC), but the efficacy is unsatisfactory. Cancer stem cells (CSCs) play key roles in chemotherapy resistance. Gene amplified in squamous cell carcinoma 1 (GASC1) is a neoteric gene in stemness maintaining of ESCC. We aimed to reveal whether GASC1 could be a predictive biomarker for NCT in ESCC. ESCC patients (T2-4N0-2M0) were evaluated for GASC1 expression using immunohistochemical staining and classified as GASC1-low group (GLG) and GASC1-high group (GHG). NCT was delivered in two cycles and then the surgery was completed. Primary endpoints were tumor regression grade (TRG) and objective response rate (ORR); secondary endpoints were radical surgical resection (R0) rate and three-year overall survival (OS). 60 patients were eligible with evaluable outcomes: 24 in GHG and 36 in GLG. Between GHG and GLG, TRG1, TRG2, TRG3, and TRG4 were 0 : 16.7%, 20.8% : 41.7%, 58.3% : 36.1%, and 20.8% : 5.6%, respectively (P=0.006); ORR and R0 rate were 33.3% : 69.4% (P=0.006) and 75% : 94.4% (P=0.046), respectively; the median OS was 20 : 32 (months) (P=0.0356). No significant difference in the three-year OS was observed between GHG and GLG: 29.2% : 41.7% (P=0.24). Furthermore, the GASC1 expression level was associated with poor OS independent of other factors by univariate and multivariate analyses. Therefore, GASC1 might be a potential biomarker to predict NCT efficacy for ESCC.