Prognosis and tumor biology of pancreatic cancer patients with isolated lung metastases: translational results from the German multicenter AIO-YMO-PAK-0515 study

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S.F. Kruger¹  A. Lohneis²  A. Abendroth⁴  A.W. Berger⁵  T.J. Ettrich⁵  O. Waidmann⁶  M. Kapp⁸  B. Steiner⁹  J. Kumbrink^1,10  A. Reischer¹  M. Haas¹  C.B. Westphalen¹  D. Zhang¹  L. Miller-Phillips¹  P.J. Burger¹  S. Kobold^1,11  J. Werner^1,13  M. Subklewe¹  M. von Bergwelt-Baildon¹  V. Kunzmann⁸  T. Seufferlein⁵  J.T. Siveke⁴  M. Sinn²  V. Heinemann¹  S. Ormanns^1,10  S. Boeck¹ 

[1] Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich;Charité—Universitätsmedizin Berlin, Department of Medical Oncology and Hematology;Department of Internal Medicine I, University Hospital Cologne;Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen;Department of Internal Medicine I, Ulm University;Department of Internal Medicine I, University Hospital Frankfurt, Johann Wolfgang Goethe-University;University Cancer Centre Frankfurt, University Hospital Frankfurt, Johann Wolfgang Goethe-University;Division of Medical Oncology, Department of Internal Medicine II, University Hospital Wuerzburg and Comprehensive Cancer Center Mainfranken;Department of Hematology and Oncology, University of Rostock;Institute of Pathology, Ludwig-Maximilians-University of Munich;German Cancer Consortium;Center for Integrated Protein Science Munich and Division of Clinical Pharmacology, Department of Medicine IV, Klinikum der Ludwig-Maximilians-University of Munich;Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich;Department of Hematology and Oncology, University Medical Center Hamburg-Eppendorf

关键词: chemotherapy;    gene expression;    lung metastasis;    pancreatic cancer;    prognosis;   

DOI  :  10.1016/j.esmoop.2022.100388

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background Pulmonary metastasis (M1-PUL) as first site of dissemination in pancreatic ductal adenocarcinoma (PDAC) is a rare event and may define a distinct biological subgroup.Patients and methods Arbeitsgemeinschaft Internistische Onkologie-Young Medical Oncologists-Pankreas-0515 study (AIO-YMO-PAK-0515) was a retrospective German multicenter study investigating clinical and molecular characteristics of M1-PUL PDAC patients; 115 M1-PUL PDAC patients from 7 participating centers were included. Clinical characteristics and potential prognostic factors were defined within the M1-PUL cohort. Archival tumor samples were analyzed for Her2/neu, HNF1A and KRT81 expression. Additionally, messenger RNA (mRNA) expression analysis (using a 770-gene immune profiling panel) was carried out in the M1-PUL and in a control cohort (M1-ANY).Results Median overall survival in the entire M1-PUL cohort was 20 months; the most favorable prognosis (median survival: 28 months) was observed in the subgroup of 66 PDAC patients with metachronous lung metastases after previous curative-intent surgery. The number of metastatic lesions, uni- or bilateral lung involvement as well as metastasectomy were identified as potential prognostic factors. Her2/neu expression and PDAC subtyping (by HNF1A and KRT81) did not differ between the M1-PUL and the M1-ANY cohort. mRNA expression analysis revealed significant differentially expressed genes between both cohorts: CD63 and LAMP1 were among the top 20 differentially expressed genes and were identified as potential mediators of organotropism and favorable survival outcome of M1-PUL patients.Conclusion M1-PUL represents a clinically favorable cohort in PDAC patients. Site of relapse might already be predetermined at the time of surgery and could potentially be predicted by gene expression profiling.

【 授权许可】

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