A subset of diffuse-type gastric cancer is susceptible to mTOR inhibitors and checkpoint inhibitors

Mechanistic target of rapamycin (mTOR) pathway is essential for the growth of gastric cancer (GC), but mTOR inhibitor everolimus was not effective for the treatment of GCs. The Cancer Genome Atlas (TCGA) researchers reported that most diffuse-type GCs were genomically stable (GS). Pathological analy...

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Published in:Journal of experimental & clinical cancer research 2019-03, Vol.38 (1), p.127-127, Article 127
Main Authors: Fukamachi, Hiroshi, Kim, Seon-Kyu, Koh, Jiwon, Lee, Hye Seung, Sasaki, Yasushi, Yamashita, Kentaro, Nishikawaji, Taketo, Shimada, Shu, Akiyama, Yoshimitsu, Byeon, Sun-Ju, Bae, Dong-Hyuck, Okuno, Keisuke, Nakagawa, Masatoshi, Tanioka, Toshiro, Inokuchi, Mikito, Kawachi, Hiroshi, Tsuchiya, Kiichiro, Kojima, Kazuyuki, Tokino, Takashi, Eishi, Yoshinobu, Kim, Yong Sung, Kim, Woo Ho, Yuasa, Yasuhito, Tanaka, Shinji
Format: Article
Language:English
Subjects:
Analysis
Cancer
Cancer therapies
Development and progression
Diffuse-type gastric cancer
Drug therapy
Ethylenediaminetetraacetic acid
Gastric cancer
Gene expression
Genetic aspects
Genomes
Genomics
Immune checkpoint inhibitor
Medical prognosis
Microsatellite unstable
mTOR inhibitor
Mutation
Patients
PIK3CA
Stem cells
Stomach cancer
Targeted cancer therapy
Temsirolimus
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Summary:Mechanistic target of rapamycin (mTOR) pathway is essential for the growth of gastric cancer (GC), but mTOR inhibitor everolimus was not effective for the treatment of GCs. The Cancer Genome Atlas (TCGA) researchers reported that most diffuse-type GCs were genomically stable (GS). Pathological analysis suggested that some diffuse-type GCs developed from intestinal-type GCs. We established patient-derived xenograft (PDX) lines from diffuse-type GCs, and searched for drugs that suppressed their growth. Diffuse-type GCs were classified into subtypes by their gene expression profiles. mTOR inhibitor temsirolimus strongly suppressed the growth of PDX-derived diffuse-type GC-initiating cells, which was regulated via Wnt-mTOR axis. These cells were microsatellite unstable (MSI) or chromosomally unstable (CIN), inconsistent with TCGA report. Diffuse-type GCs in TCGA cohort could be classified into two clusters, and GS subtype was major in cluster I while CIN and MSI subtypes were predominant in cluster II where PDX-derived diffuse-type GC cells were included. We estimated that about 9 and 55% of the diffuse-type GCs in cluster II were responders to mTOR inhibitors and checkpoint inhibitors, respectively, by identifying PIK3CA mutations and MSI condition in TCGA cohort. These ratios were far greater than those of diffuse-type GCs in cluster I or intestinal-type GCs. Further analysis suggested that diffuse-type GCs in cluster II developed from intestinal-type GCs while those in cluster I from normal gastric epithelial cells. mTOR inhibitors and checkpoint inhibitors might be useful for the treatment of a subset of diffuse-type GCs which may develop from intestinal-type GCs.
ISSN:1756-9966
0392-9078
1756-9966
DOI:10.1186/s13046-019-1121-3