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Abstract：
The clinicopathological features of MET-amplified gastric cancer (GC) and real-world data on the efficacy of MET-targeted therapies remain unknown. Pulmonary lymphangitis carcinomatosis (PLC) is a peculiar manifestation of GC, whose management has not been thoroughly described.
This study analyzed patients diagnosed with MET-amplified GC or GC with PLC at any time point of the disease course from 2011 to 2021 in two centers. Clinicopathological features and survival outcomes of MET-amplified GC were analyzed. The clinical and molecular implications of GC with PLC were discussed.
Fifty-eight patients with MET-amplified GC and 20 patients with GC accompanied by PLC were finally enrolled for analysis (including 13 overlapped patients). GC with PLC was more common in female patients (p = 0.010), diagnosed at a younger age (p = 0.002), presented with a higher baseline ECOG PS (p = 0.016), and was more likely to develop lung metastasis (p < 0.001), and serous effusion (p = 0.026) than GC without PLC. Patients with primary MET-amplified GC had a worse prognosis than those with secondary MET-amplified GC (p = 0.005). The application of anti-MET therapy was associated with numerically prolonged survival, but the association was not statistically significant (p = 0.07). MET amplification was concentrated in patients with PLC, in which anti-MET therapies elicited a high response rate.
MET-targeted therapies are efficacious in real-world populations with MET-amplified GC. Patients with PLC have distinct clinical and molecular features and might benefit from MET-targeted therapies.
This study analyzed patients diagnosed with MET-amplified GC or GC with PLC at any time point of the disease course from 2011 to 2021 in two centers. Clinicopathological features and survival outcomes of MET-amplified GC were analyzed. The clinical and molecular implications of GC with PLC were discussed.
Fifty-eight patients with MET-amplified GC and 20 patients with GC accompanied by PLC were finally enrolled for analysis (including 13 overlapped patients). GC with PLC was more common in female patients (p = 0.010), diagnosed at a younger age (p = 0.002), presented with a higher baseline ECOG PS (p = 0.016), and was more likely to develop lung metastasis (p < 0.001), and serous effusion (p = 0.026) than GC without PLC. Patients with primary MET-amplified GC had a worse prognosis than those with secondary MET-amplified GC (p = 0.005). The application of anti-MET therapy was associated with numerically prolonged survival, but the association was not statistically significant (p = 0.07). MET amplification was concentrated in patients with PLC, in which anti-MET therapies elicited a high response rate.
MET-targeted therapies are efficacious in real-world populations with MET-amplified GC. Patients with PLC have distinct clinical and molecular features and might benefit from MET-targeted therapies.
摘要：
背景：MET扩增型胃癌（GC）的临床病理特征和MET靶向治疗疗效的真实世界数据仍然未知。肺淋巴管炎癌病(PLC)是GC的一种特殊表现,其管理尚未得到彻底描述。
方法：本研究分析了两个中心在2011年至2021年病程的任何时间点诊断为MET扩增的GC或具有PLC的GC的患者。分析MET扩增GC的临床病理特征和生存结果。讨论了GC与PLC的临床和分子意义。
结果：最终纳入58例MET扩增GC患者和20例GC伴PLC患者（包括13例重叠患者）进行分析。GC合并PLC在女性患者中更为常见（p=0.010），诊断为年轻（p=0.002），呈现较高的基线ECOGPS(p=0.016)，并且更容易发生肺转移（p<0.001），浆液性积液(p=0.026)高于无PLC的GC。原发性MET扩增的GC患者的预后比继发性MET扩增的GC患者差（p=0.005）。抗MET治疗的应用与数字上延长的生存期相关，但相关性无统计学意义(p=0.07).MET扩增集中在PLC患者中，其中抗MET疗法引起高反应率。
结论：MET靶向治疗在MET扩增GC的真实世界人群中是有效的。PLC患者具有不同的临床和分子特征，可能受益于MET靶向治疗。
方法：本研究分析了两个中心在2011年至2021年病程的任何时间点诊断为MET扩增的GC或具有PLC的GC的患者。分析MET扩增GC的临床病理特征和生存结果。讨论了GC与PLC的临床和分子意义。
结果：最终纳入58例MET扩增GC患者和20例GC伴PLC患者（包括13例重叠患者）进行分析。GC合并PLC在女性患者中更为常见（p=0.010），诊断为年轻（p=0.002），呈现较高的基线ECOGPS(p=0.016)，并且更容易发生肺转移（p<0.001），浆液性积液(p=0.026)高于无PLC的GC。原发性MET扩增的GC患者的预后比继发性MET扩增的GC患者差（p=0.005）。抗MET治疗的应用与数字上延长的生存期相关，但相关性无统计学意义(p=0.07).MET扩增集中在PLC患者中，其中抗MET疗法引起高反应率。
结论：MET靶向治疗在MET扩增GC的真实世界人群中是有效的。PLC患者具有不同的临床和分子特征，可能受益于MET靶向治疗。
