KMID : 0620920210530020223
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Experimental & Molecular Medicine 2021 Volume.53 No. 2 p.223 ~ p.234
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Practical prediction model of the clinical response to programmed death-ligand 1 inhibitors in advanced gastric cancer
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Noh Myung-Giun
Yoon Young-Min Kim Gi-Hyeon Kim Hyun Lee Eul-Gi Kim Yeong-Min Park Chang-Ho Lee Kyung-Hwa Park Han-Soo
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Abstract
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The identification of predictive biomarkers or models is necessary for the selection of patients who might benefit the most from immunotherapy. Seven histological features (signet ring cell [SRC], fibrous stroma, myxoid stroma, tumor-infiltrating lymphocytes [TILs], necrosis, tertiary lymphoid follicles, and ulceration) detected in surgically resected tissues (N?=?44) were used to train a model. The presence of SRC became an optimal decision parameter for pathology alone (AUC?=?0.78). Analysis of differentially expressed genes (DEGs) for the prediction of genomic markers showed that C-X-C motif chemokine ligand 11 (CXCL11) was high in responders (P?0.001). Immunohistochemistry (IHC) was performed to verify its potential as a biomarker. IHC revealed that the expression of CXCL11 was associated with responsiveness (P?=?0.003). The response prediction model was trained by integrating the results of the analysis of pathological factors and RNA sequencing (RNA-seq). When trained with the C5.0 decision tree model, the categorical level of the expression of CXCL11, a single variable, was shown to be the best model (AUC?=?0.812). The AUC of the model trained with the random forest was 0.944. Survival analysis revealed that the C5.0-trained model (log-rank P?=?0.01 for progression-free survival [PFS]; log-rank P?=?0.012 for overall survival [OS]) and the random forest-trained model (log-rank P?0.001 for PFS; log-rank P?=?0.001 for OS) predicted prognosis more accurately than the PD-L1 test (log-rank P?=?0.031 for PFS; log-rank P?=?0.107 for OS).
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KEYWORD
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Predictive markers, Predictive medicine, Translational research
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