Vascular endothelial growth factor-A is an Immunohistochemical biomarker for the efficacy of bevacizumab-containing chemotherapy for duodenal and jejunal adenocarcinoma

BMC Cancer

Tsunekazu Mizushima¹  Hidekazu Takahashi¹  Motohiro Hirao²  Tetsuo Takehara³  Taku Tashiro³  Yuriko Otake³  Takahiro Amano³  Takahiro Inoue³  Yoshito Hayashi³  Mizuki Tani³  Shinichiro Shinzaki³  Hideki Iijima³  Takeo Yoshihara³  Yoshiki Tsujii³  Koji Nagaike⁴  Jun Murata⁵  Masato Komori⁶  Satoshi Hiyama⁷  Shinjiro Yamaguchi⁸  Manabu Araki⁹  Yuko Sakakibara^1,10  Hiroyuki Ogawa^1,11  Kazuo Kinoshita^1,12  Yorihide Okuda^1,13  Aya Sugimoto^1,14  Takashi Kizu^1,15  Shuko Iwatani^1,16  Satoshi Egawa^1,16  Eiichi Morii^1,17 

[1] Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan;Department of Gastroenterology and Hepatology, Osaka Rosai Hospital, Sakai, Osaka, Japan;Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan;Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Suita, Osaka, Japan;Department of Gastroenterology, Higashiosaka City Medical Center, Higashiosaka, Osaka, Japan;Department of Gastroenterology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan;Department of Gastroenterology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan;Department of Gastroenterology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan;Department of Gastroenterology, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka, Japan;Department of Gastroenterology, National Hospital Organization Osaka National Hospital, Osaka, Japan;Department of Gastroenterology, Nishinomiya Municipal Central Hospital, Nishinomiya, Hyogo, Japan;Department of Gastroenterology, Otemae Hospital, Osaka, Japan;Department of Gastroenterology, Saiseikai Senri Hospital, Suita, Osaka, Japan;Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan;Department of Gastroenterology, Yao Municipal Hospital, Yao, Osaka, Japan;Department of Internal Medicine, Osaka Police Hospital, Osaka, Japan;Department of Pathology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan;

关键词: Small bowel adenocarcinoma;    Duodenal and jejunal adenocarcinoma;    VEGF-A;    Immunohistochemical expressions;    Bevacizumab;   

DOI  :  10.1186/s12885-021-08724-5

来源: Springer

【 摘 要 】

BackgroundThe efficacy and safety of bevacizumab-containing chemotherapy for patients with metastatic duodenal and jejunal adenocarcinoma (mDJA) are unclear. The present study aimed to evaluate the efficacy of bevacizumab and to explore immunohistochemical markers that can predict the efficacy of bevacizumab for patients with mDJA.MethodsThis multicentre study included patients with histologically confirmed small bowel adenocarcinoma who received palliative chemotherapy from 2008 to 2017 at 15 hospitals. Immunostaining was performed for vascular endothelial growth factor-A (VEGF-A), TP53, Ki67, β-catenin, CD10, MUC2, MUC5AC, MUC6, and mismatch repair proteins.ResultsA total of 74 patients were enrolled, including 65 patients with mDJA and 9 with metastatic ileal adenocarcinoma. Patients with mDJA who received platinum-based chemotherapy with bevacizumab as first-line treatment tended to have a longer progression-free survival and overall survival than those treated without bevacizumab (P = 0.075 and 0.077, respectively). Multivariate analysis extracted high VEGF-A expression as a factor prolonging progression-free survival (hazard ratio: 0.52, 95% confidence interval: 0.30–0.91). In mDJA patients with high VEGF-A expression, those who received platinum-based chemotherapy with bevacizumab as a first-line treatment had significantly longer progression-free survival and tended to have longer overall survival than those treated without bevacizumab (P = 0.025 and P = 0.056, respectively), whereas no differences were observed in mDJA patients with low VEGF-A expression.ConclusionImmunohistochemical expression of VEGF-A is a potentially useful biomarker for predicting the efficacy of bevacizumab-containing chemotherapy for patients with mDJA.

【 授权许可】

CC BY