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Pulmonary lymphangitis carcinomatosis: A peculiar presentation clustering in MET-amplified gastric cancer
Zhening Zhang1, Yiyi Yu2, Tong Xie1
1State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
Insights
MET-targeted therapies show efficacy in MET-amplified gastric cancer (GC). Patients with pulmonary lymphangitis carcinomatosis (PLC) have unique features and may benefit from these MET-targeted treatments.
Area of Science:
- Oncology
- Gastroenterology
- Molecular Biology
Background:
- Clinicopathological features of MET-amplified gastric cancer (GC) are not well-defined.
- Real-world data on MET-targeted therapies for GC is limited.
- Pulmonary lymphangitis carcinomatosis (PLC) is a rare GC manifestation with unclear management.
Purpose of the Study:
- To analyze clinicopathological features of MET-amplified GC.
- To evaluate real-world efficacy of MET-targeted therapies.
- To explore clinical and molecular implications of GC with PLC.
Main Methods:
- Retrospective analysis of 78 patients with MET-amplified GC or GC with PLC (2011-2021).
- Comparison of clinicopathological characteristics and survival outcomes.
- Assessment of MET-targeted therapy response in PLC patients.
Main Results:
- GC with PLC showed distinct features: more common in females, younger age, higher ECOG PS, increased lung metastasis and serous effusion.
- Primary MET-amplified GC had a worse prognosis than secondary.
- Anti-MET therapy showed a trend towards prolonged survival (not statistically significant), but high response rates in PLC patients with MET amplification.
Conclusions:
- MET-targeted therapies are effective in real-world MET-amplified GC.
- Patients with PLC exhibit unique characteristics and may benefit from MET-targeted treatments.
