This studyaimed to assess the effectiveness of combining the anti-PD-1 drug with regorafenib and raltitrexed as a third-line treatment for mCRC. We conducted a retrospective analysis of patients diagnosed with metastatic colorectal cancer between December 2021 and December 2022, who had previously failed treatment and subsequently received anti-PD-1 drugs combined with regorafenib and raltitrexed as third-line therapy. The primary efficacy endpoints were the objective response rate (ORR) and progression-free survival (PFS), while secondary endpoints included the disease control rate (DCR) and overall survival (OS). A total of 57 patients were enrolled in the study. The ORR and DCR were 14.1

Digestive system cancers represent a group of malignancies with high global incidence and a particularly heavy disease burden in China. Among these, gastric cancer, colorectal cancer, and biliary tract cancer represent critical human epidermal growth factor receptor 2 (HER2)-positive subtypes that require focused clinical attention. Antibody–drug conjugates (ADCs), which utilize HER2-targeted monoclonal antibodies to deliver cytotoxic agents directly to tumor cells, have revolutionized precision therapy in HER2-positive cancers, marking a significant milestone in oncologic treatment. Currently, trastuzumab deruxtecan and disitamab vedotin have been approved for the treatment of advanced gastric cancer. This expert consensus emphasizes the safety management of HER2 ADCs in digestive system cancers, considering the unique anatomical complexity and the vulnerability of the mucosal barrier in this system. It underscores the essential role of multidisciplinary team collaboration in standardizing the management of adverse events and offers evidence-based recommendations to guide clinical practice across primary and secondary care settings. Furthermore, it underscores the value of a “physician-led, patient-engaged” model in patient education. The safety management experience accumulated in this context also offers important insights for the clinical application of ADCs targeting other oncogenic pathways.

Following the publication of this paper, it was drawn to the Editor's attention by a concerned reader that certain of the western blot data shown in Fig. 4 on p. 521 were strikingly similar to data that had already appeared in a pair of figures in a previously published article written by different authors at different research institutes in the journal Molecular Cancer Therapeutics. In addition, there was an unexpected issue with the appearance of the shading surrounding one of the tumor images featured in Fig. 7, such that this figure appeared to contain an anomaly. Owing to the fact that contentious western blot data in the above article had already been published prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 43: 516‑524, 2020; DOI: 10.3892/or.2019.7425].

e15510 Background: Thisstudy aimed to assess the effectiveness of combining the anti-PD-1 drug with regorafenib and raltitrexed as a third-line treatment for mCRC. Methods: We conducted a retrospective analysis of patients diagnosed with metastatic colorectal cancer between December 2021 and December 2022, who had previously failed treatment and subsequently received anti-PD-1 drugs combined with regorafenib and raltitrexed as third-line therapy. The primary efficacy endpoints were the objective response rate (ORR) and PFS, while secondary endpoints included the disease control rate (DCR) and OS. Results: A total of 57 patients were enrolled in the study. The ORR and DCR were 14.1% (95% confidence interval [CI]: 5.1–23.1) and 50.9% (95% CI: 37.9–63.9), respectively. No patient achieved CR, 8 (14.1%) patients exhibited PR, 21 (36.8%) patients had SD, and 26 (49.1%) patients experienced PD.At the data cutoff, 23 (40.4%) deaths had occurred; with a median follow-up of 11 months (range 1-32.6). The median PFS was 4.2 months (95% CI: 1.7 to 6.7), and the median OS was 10.5 months (95% CI: 3.0 to 18.0). Treatment-related adverse events (TRAEs) of any grade occurred in 50 (87.7%) patients, with the most common being palmar-plantar erythrodysesthesia (25, 43.9%), followed by a rash (7, 12.3%), and hypertension (5, 8.8%). Conclusions: The combination of anti-PD-1 drugs, regorafenib, and raltitrexed demonstrated promising antitumor efficacy and acceptable safety in patients with metastatic CRC, offering an alternative approach to optimize combination strategies in the management of refractory metastatic colorectal cancer. Clinicopathological characteristics. Variables ALL patients (N=57) Age (years) Median, range 53 (30–71) Gender Male 35 (61.4%) Female 22 (38.6%) Location Right-side colon 18 (31.6%) Left-side colon or rectum 39 (68.4%) ECOG Performance status 0 16 (28.1%) 1 41 (71.9%) Postoperation Yes 41 (71.9%) Not 16 (28.1%) Radiotherapy Yes 20 (35.1%) Not 37 (64.9%) Site of metastases Liver 30 (52.6%) Lung 15 (26.3%) Peritoneum 8 (14%) Lymph node 5 (8.7%) Bone 5 (8.7%) Number of metastatic organs <2 39 (68.4%) ≥2 18 (31.6%） Gene type (N=41) RAS mutations 16 (39.0%) BRAF mutations 5 (12.2%) PD-1 Sintilimab 32 (56.1%) Camrelizumab 9 (15.8%) Nivolumab 7 (12.3%) Toripalimab 4 (7%) Tislelizumab 3 (5.3%) Pembrolizumab 2 (3.5%) Cycle of treatment ≤2 29 (50.9%） >2 28 (49.1%)

4010 Background: LBL-024 blocks the immunosuppressive pathway of tumor cells by targeting PD-L1 and effectively localizes 4-1BB co-stimulation to the tumor microenvironment, to improve the anti-tumor immune response. Here we report the safety and efficacy of LBL-024 in patients with advanced malignant tumors, particularly the robust clinical benefit in extrapulmonary neuroendocrine carcinoma (EP-NEC). Methods: Patient population: Phase Ⅰ, advanced malignant tumors exhausted standard cares and phase Ⅱ, EP-NEC failed at least one line of chemotherapy. Seven dose levels of LBL-024 were evaluated (0.2, 0.8, 3.2, 6, 10, 15 and 25 mg/kg, i.v. Q3W) and 15 mg/kg was selected for phase Ⅱ. The primary endpoints were tolerability, safety and efficacy (RECIST 1.1) and the second objectives were pharmacokinetics, pharmacodynamics, and other efficacy parameters. Results: By October 31, 2023, 162 patients were enrolled (64 in phase Ⅰ, and 98 in phase Ⅱ). Tumor types include EP-NEC (46, 28.4%), NSCLC (33, 20.4%), biliary tract cancer (31, 19.1%), and other tumors (52, 32.1%). During the dose escalation stage, no DLT was observed, and the MTD was not reached. The median follow-up was 4.2 months (95%CI: 3.9, 4.9). 126 out of 162 patients (77.8%) experienced TRAEs of all grades, with 34 (21.0%) having grade ≥3 TRAEs. The most common TRAEs (≥15%) included anemia (31.5%), AST increased (30.9%), ALT increased (25.3%), and white blood cell count decreased (22.2%). Out of 146 who underwent efficacy evaluation, the ORR and DCR were 15.1% and 46.6%, respectively. Robust efficacy signals were observed in 41 patients with EP-NEC (Table 1). 6 months of DoR will be available for report in ASCO. Conclusions: LBL-024 has showed good safety profile and very promising antitumor effects in patients with advanced malignant tumors, particularly EP-NEC patients who failed at least one line of chemotherapy. The efficacy observed in EP-NEC is significantly higher than the historic reports with immunotherapy (≤10%) and chemotherapy (about 18%). The extremely robust efficacy and good safety profile support a pivotal study for accelerated development of EP-NEC, the highly unmet medical needs and deadly disease. Clinical trial information: NCT05170958 . [Table: see text]

This study aims to determine the clinical features and outcomes of PD-1 inhibitor therapy as the initial treatment in patients aged 65 years or older with locally advanced or metastatic esophageal squamous cell carcinoma (ESCC). The retrospective study conducted a comprehensive analysis of elder patients diagnosed with locally advanced or metastatic ESCC who underwent combined immunochemotherapy in the first affiliated hospital of Nanchang University from January 2019 to January 2023. The main efficacy measures were the objective response rate (ORR) and progression-free survival (PFS). The secondary endpoints were disease control rate (DCR) and overall survival (OS). The evaluation of safety was based on the assessment of adverse events (AEs). A total of 88 patients were enrolled in the study. All patients received PD-1 inhibitors combined with chemotherapy including taxane and platinum as the first-line treatment. The median PFS was 6.2 months (95

Background: Cholangiocarcinoma (CCA) is the second most common primary malignancy of the liver and is associated with poor prognosis. Despite the emerging role of glycine amidinotransferase (GATM) in cancer development, its function in CCA remains elusive. This study investigated the biological significance and molecular mechanisms of GATM in CCA. Method: GATM expression was measured using immunohistochemistry and western blotting. Cell proliferation, migration, and invasion were assessed through CCK-8, EdU, clone formation, wound healing, and Transwell assays. Rescue experiments were performed to determine whether the JNK/c-Jun pathway is involved in GATM-mediated CCA development. Immunoprecipitation and mass spectrometry were performed to screen for proteins that interact with GATM. The role of GATM in vivo was investigated according to the xenograft experiment. Result: GATM expression was downregulated in CCA tissues and cells (p < 0.05) and had a significant suppressive effect on CCA cell proliferation, migration, and invasion in vitro as well as on tumour growth in vivo (p < 0.05); conversely, GATM knockdown promoted these phenotypes (p < 0.05). Notably, GATM inhibited the JNK/c-Jun pathway, and JNK activation abrogated GATM's antitumor effects (p < 0.05). Isocitrate dehydrogenase 1 (IDH1) interacts with GATM, and IDH1 knockdown significantly attenuated GATM protein degradation. Overexpression of IDH1 restored the biological function of CCA by reversing the inhibition of JNK/c-Jun pathway phosphorylation by GATM (p < 0.05). Conclusion: GATM acts as a tumour suppressor in CCA by regulating the phosphorylation of the JNK/c-Jun pathway. IDH1 interacted with GATM to regulate CCA progression.

Prostate cancer (PCa) is a high-mortality cancer. Docetaxel (DCT) combined with second-generation anti-androgens is considered the golden standard therapy for PCa, whose application is limited for DCT resistance (DR). Therefore, exploring the mechanism of DR is of great importance. In this study, PCa cell lines of PC3 and DU145 were employed, and DR cells were constructed by treatment with graded DCT. CircSLC4A7, miR-1205, and microtubule-associated protein tau (MAPT) transfections were established. Cell counting kit-8 assay was performed to evaluate the cell activity and IC50 of DCT. After being treated with DCT, DR was assessed by colony formation assay, flow cytometry analysis, and terminal transferase-mediated UTP nick end-labeling assay. Real-time quantitative PCR and western blotting analysis evaluated the expression levels of genes. The dual-luciferase reporter gene assay verified the miR-1205 binding sites with circSLC4A7 and MAPT. An animal experiment was performed to assess the tumor growth influenced by circSLC4A7. After conducting DR cells and isolated exosomes, we found that not only co-culture with DR cells but also treatment with DR cells' exosomes would promote the DR of normal cells. Moreover, circSLC4A7 was highly expressed in DR cells and their exosomes. CircSLC4A7 overexpression enhanced DR, represented as raised IC50 of DCT, increased colony formation, and decreased cell apoptosis after DCT treatment, while circSLC4A7 knockdown had the opposite effect. MiR-1205 was confirmed as a circSLC4A7-sponged miRNA and miR-1205 inhibitor reversed the effect of sh-circSLC4A7. MAPT was further identified as a target of miR-1205 and had a similar effect with circSLC4A7. The effect of circSLC4A7 on DR was also confirmed by xenograft experiments. Collectively, circSLC4A7 in resistant-cells-derived exosomes promotes DCT resistance of PCa via miR-1205/MAPT axis, which may provide a new treatment strategy for DR of PCa.

BackgroundIn the ongoing, randomised, double-blind phase 3 TOPAZ-1 study, durvalumab, a PD-L1 inhibitor, plus gemcitabine and cisplatin was associated with significant improvements in overall survival compared with placebo, gemcitabine, and cisplatin in people with advanced biliary tract cancer at the pre-planned intermin analysis. In this paper, we present patient-reported outcomes from TOPAZ-1.MethodsIn TOPAZ-1 (NCT03875235), participants aged 18 years or older with previously untreated, unresectable, locally advanced, or metastatic biliary tract cancer with an Eastern Cooperative Oncology Group performance status of 0 or 1 and one or more measurable lesions per Response Evaluation Criteria in Solid Tumors (RECIST; version 1.1) were randomly assigned (1:1) to the durvalumab group or the placebo group using a computer-generated randomisation scheme. Participants received 1500 mg durvalumab or matched placebo intravenously every 3 weeks (on day 1 of the cycle) for up to eight cycles in combination with 1000 mg/m2 gemcitabine and 25 mg/m2 cisplatin intravenously on days 1 and 8 every 3 weeks for up to eight cycles. Thereafter, participants received either durvalumab (1500 mg) or placebo monotherapy intravenously every 4 weeks until disease progression or other discontinuation criteria were met. Randomisation was stratified by disease status (initially unresectable vs recurrent) and primary tumour location (intrahepatic cholangiocarcinoma vs extrahepatic cholangiocarcinoma vs gallbladder cancer). Patient-reported outcomes were assessed as a secondary outcome in all participants who completed the European Organisation for Research and Treatment of Cancer's 30-item Quality of Life of Cancer Patients questionnaire (QLQ-C30) and the 21-item Cholangiocarcinoma and Gallbladder Cancer Quality of Life Module (QLQ-BIL21). We calculated time to deterioration—ie, time from randomisation to an absolute decrease of at least 10 points in a patient-reported outcome that was confirmed at a subsequent visit or the date of death (by any cause) in the absence of deterioration—and adjusted mean change from baseline in patient-reported outcomes.FindingsBetween April 16, 2019, and Dec 11, 2020, 685 participants were enrolled and randomly assigned, 341 to the durvalumab group and 344 to the placebo group. Overall, 345 (50%) of participants were male and 340 (50%) were female. Data for the QLQ-C30 were available for 318 participants in the durvalumab group and 328 in the placebo group (median follow-up 9·9 months [IQR 6·7 to 14·1]). Data for the QLQ-BIL21 were available for 305 participants in the durvalumab group and 322 in the placebo group (median follow-up 10·2 months [IQR 6·7 to 14·3]). The proportions of participants in both groups who completed questionnaires were high and baseline scores were mostly similar across treatment groups. For global health status or quality of life, functioning, and symptoms, we noted no difference in time to deterioration or adjusted mean changes from baseline were observed between groups. Median time to deterioration of global health status or quality of life was 7·4 months (95% CI 5·6 to 8·9) in the durvalumab group and 6·7 months (5·6 to 7·9) in the placebo group (hazard ratio 0·87 [95% CI 0·69 to 1·12]). The adjusted mean change from baseline was 1·23 (95% CI –0·71 to 3·16) in the durvalumab group and 0·35 (–1·63 to 2·32) in the placebo group.InterpretationThe addition of durvalumab to gemcitabine and cisplatin did not have a detrimental effect on patient-reported outcomes. These results suggest that durvalumab, gemcitabine, and cisplatin is a tolerable treatment regimen in patients with advanced biliary tract cancer.FundingAstraZeneca.

Background: Neoadjuvant therapy has become a mainstay of treatment for locally advanced resectable esophageal cancer. The objective of this research was to investigate the effectiveness and safety of neoadjuvant immunotherapy combined with chemotherapy in treating surgically removable esophageal Methods: From January 1, 2016 to April 1, 2023, we conducted a retrospective analysis of patients diagnosed with resectable esophageal cancer who underwent neoadjuvant immunotherapy combined with chemotherapy at The First Affiliated Hospital of Nanchang University. The primary endpoints of this study were pathologic complete response (pCR), major pathologic response (MPR) and disease-free survival (DFS). The secondary endpoints of this study were overall survival (OS), objective response rate (ORR) and safety. Results: A total of 122 patients with ESCC receiving neoadjuvant immune-chemotherapy (nICT) were included. Fifty-four patients achieved partial response (PR) and two patients achieved complete response (CR), with an ORR of 45.9%. Of the 106 patients who underwent surgery, a total of 28 patients achieved pCR (26.4%) and a total of 37 patients achieved MPR (34.9%). Grade 3 or higher adverse events occurred in 26 patients (21.3%). The most common postoperative complication was pneumonitis (25.5%). Conclusions: Neoadjuvant immunotherapy combined with chemotherapy demonstrates satisfactory efficacy in the treatment of locally advanced ESCC, with manageable treatment-related adverse events and postoperative complications.

To explore the clinicopathological characteristics, survival outcomes, and prognosis of very young gastric cancer (GC). From January 1, 2011 to January 1, 2021, GC patients under 30 years old treated in three tertiary hospitals were enrolled. Clinicopathological characteristics were summarized, prognostic factors and survival outcomes including overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) were retrospectively analyzed. One hundred patients were finally included, with a median age of 23 years.73 (73.0

550 Background: TOPAZ-1 (NCT03875235) is a double-blind, Phase 3 study of durvalumab (D), an immune checkpoint inhibitor (ICI), + gemcitabine and cisplatin (GC) in participants (pts) with advanced biliary tract cancer (BTC). D + GC improved overall survival (OS) in pts with advanced BTC versus placebo (PBO) + GC (Oh et al. NEJM Evid 2022). Use of antibiotics during ICI treatment has been correlated with poorer OS and progression-free survival (PFS; Jiang et al. Front Oncol 2022). Methods: Pts were randomized 1:1 to receive D (1500 mg) or PBO on Day 1 every 3 weeks (Q3W), + G (1000 mg/m2) and C (25 mg/m2) on Days 1 and 8 Q3W, for ≤8 cycles, followed by D or PBO monotherapy Q4W. This exploratory subgroup analysis of TOPAZ-1 assessed OS and PFS by systemic antibiotic use during the study (≥1 dose 14 days before first D/PBO dose to 14 days after last D/PBO dose). Hazard ratios (HRs) were estimated using an unstratified Cox proportional hazards model, adjusting for disease status (initially unresectable or recurrent) and primary tumor location (intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, or gallbladder cancer). Data cut-off at primary analysis was Aug 11, 2021. Results: The number (%) of pts using antibiotics during the study (D + GC, 167/341 [49.0%]; PBO + GC, 167/344 [48.5%]) was similar between treatment arms. In the D + GC arm, median OS (95% CI) was similar regardless of antibiotics use: 12.6 (9.7–14.8) months in pts with antibiotics use vs 13.0 (10.8–14.7) months in pts without (Table). In the PBO + GC arm, median OS (95% CI) was 10.3 (8.7–12.5) in pts with antibiotics use vs 12.1 (11.0–13.8) in pts without. OS HRs (95% CI) in D + GC vs PBO + GC were 0.78 (0.59–1.02) in pts with antibiotics and 0.81 (0.62–1.07) in pts without. Median PFS (95% CI) was 7.3 (6.5–7.7) months in pts with antibiotics use vs 7.2 (5.9–7.4) months in pts without in the D + GC arm and 5.7 (5.4–6.6) months vs 6.1 (5.6–7.3) months, respectively, in the PBO + GC arm (Table). PFS HRs (95% CI) were 0.70 (0.55–0.89) in pts with antibiotics use and 0.82 (0.65–1.03) in pts without. Conclusions: In the TOPAZ-1 study of D in BTC, no meaningful difference was found in OS or PFS for participants who received antibiotics during the study period compared with those who did not, and results were consistent with the primary analysis. These results support that people receiving D may be treated with antibiotics when clinically indicated. Clinical trial information: NCT03875235 . [Table: see text]

Objective The study aimed to explore the clinical and pathological characteristics, survival outcomes, and prognostic factors of colorectal hepatoid adenocarcinoma. Methods We performed two cases of colorectal hepatoid adenocarcinoma treated at the Oncology Department of the First Affiliated Hospital of Nanchang University. We also reviewed literature up to the present and performed a retrospective study of colorectal hepatoid adenocarcinoma. Results Among the 39 patients included in this study, 28 had primary tumors in the colon, 9 in the rectum, and 2 in the rectosigmoid junction. The median age was 52 years (range 31–75 years); 28 patients (71.8%) were male. Out of the 32 patients for whom survival data were available, 24 patients succumbed to disease-related causes. The median overall survival of 32 patients was 8 months, with 1-year and 2-year overall survival rates of 31.0% and 16.0%, respectively. Univariate analysis revealed that depth of infiltration, presence of liver metastases, TNM stage, and the completeness of surgical resection were significantly associated with the overall survival period of colorectal hepatoid adenocarcinoma. Conclusion Colorectal hepatoid adenocarcinoma exhibits a high degree of aggressiveness and poor prognosis. The major strategy for early-stage HAC was radical surgery and chemoradiotherapy demonstrates limited efficacy for extending survival.

目的 探讨人表皮生长因子受体2(HER2)在三阴性早期/局部晚期乳腺癌患者中的表达及与疗效和复发转移的关系.方法 收集接受新辅助化疗的98例三阴性早期/局部晚期乳腺癌患者的临床资料,分析不同HER2表达水平患者的临床特征,采用二元Logistic回归分析和Cox回归分析对三阴性早期/局部晚期乳腺癌患者完全缓解和预后的影响因素进行分析.结果 HER2低表达患者中腋窝淋巴结转移及术后淋巴结分期为N3期患者的比例均高于HER2表达为0的患者,差异均有统计学意义(P﹤0.05).临床分期为cT3～4期、HER2低表达均是三阴性早期/局部晚期乳腺癌患者完全缓解率的危险因素(P﹤0.01).新辅助化疗后非完全缓解、HER2表达较高、术后淋巴结分期较高均是三阴性早期/局部晚期乳腺癌患者无病生存率(DFS)的危险因素(P﹤0.05).结论 临床分期为cT3～4期、HER2低表达均是三阴性早期/局部晚期乳腺癌患者完全缓解的影响因素,且新辅助化疗后非完全缓解、HER2表达较高、术后淋巴结分期较高的患者预后较差,HER2表达水平可作为预测三阴性早期/局部晚期乳腺癌患者疗效及复发转移的指标.

F-box and WD repeat domain-containing 5 (FBXW5), with WD40 repeats, can bind to the PPxY sequence of the large tumor suppressor kinases 1/2 (LATS1/2) kinase domain, resulting in ubiquitination. Ubiquitination and the subsequent degradation of LATS1/2 abrogate the Hippo pathway and worsen gastric cancer (GC). However, the effects and molecular mechanisms of FBXW5 in GC remain unexplored. To elucidate the clinical significance of FBXW5, immunohistochemistry was conducted to reveal the positive correlation between FBXW5 expression and lymph node metastasis ( p < 0.001) and TNM stage (training cohort: p = 0.018; validation cohort: p = 0.001). Further, patients with high FBXW5 expression were found to have poor prognosis (training cohort: log-rank p = 0.020; validation cohort: log-rank p = 0.025). Cell experiments revealed the promoting effects of FBXW5 on the proliferation, invasion, metastasis, and chemoresistance of GC cells. Blocking LATS1-YAP1 leads to the loss of FBXW5-mediated regulation of the Hippo pathway and partial functions. Further, co-immunoprecipitation and in vivo ubiquitination assays revealed the interaction between FBXW5 and LATS1, which promoted the ubiquitination and degradation of LATS1. Based on mouse xenograft assays, FBXW5 silencing attenuated the growth of subcutaneous tumor xenografts. Altogether, FBXW5 was found to inactivate the Hippo signaling pathway by enhancing LATS1 ubiquitination and degradation, which promoted the invasion, metastasis, and drug resistance of GC cells.

Platinum-based chemotherapy is the standard first-line treatment for advanced esophageal squamous cell carcinoma (ESCC). In this phase 3 study (ClinicalTrial.gov: NCT03829969), 514 patients with treatment-naïve advanced ESCC were randomized (1:1) to receive toripalimab or placebo in combination with paclitaxel plus cisplatin (TP) every 3 weeks for up to 6 cycles, followed by toripalimab or placebo maintenance. At the prespecified final analysis of progression-free survival (PFS), a significant improvement in PFS is observed for the toripalimab arm over the placebo arm (hazard ratio [HR] = 0.58; 95% CI, 0.46-0.74; p < 0.0001). The prespecified interim analysis of overall survival (OS) also reveals a significant OS improvement for patients treated with toripalimab plus TP over placebo plus TP (HR = 0.58; 95% CI, 0.43-0.78; p = 0.0004). The incidences of grade ≥3 treatment-emergent adverse events are similar between the two arms. Toripalimab plus TP significantly improves PFS and OS in patients with treatment-naïve, advanced ESCC, with a manageable safety profile.

The importance of the Hippo-Yes-associated protein 1 (YAP1) pathway in gastric carcinogenesis and metastasis has attracted considerable research attention; however, the regulatory network of YAP1 in gastric cancer (GC) is not completely understood. In this study, ubiquitin-specific peptidase 49 (USP49) was identified as a novel deubiquitinase of YAP1, knockdown of USP49 inhibited the proliferation, metastasis, chemoresistance, and peritoneal metastasis of GC cells. Overexpression of USP49 showed opposing biological effects. Moreover, USP49 was transcriptionally activated by the YAP1/TEAD4 complex, which formed a positive feedback loop with YAP1 to promote the malignant progression of GC cells. Finally, we collected tissue samples and clinical follow-up information from 482 GC patients. The results showed that USP49 expression was high in GC cells and positively correlated with the expression of YAP1 and its target genes, connective tissue growth factor (CTGF) and cysteine-rich angiogenic inducer 61 (CYR61). Survival and Cox regression analysis showed that high USP49 expression was associated with poor prognosis and was an independent prognostic factor. Moreover, patients with high USP49 and YAP1 expression had extremely short overall survival. The findings of this study reveal that the aberrant activation of the USP49/YAP1 positive feedback loop plays a critical role in the malignant progression of GC, thus providing potential novel prognostic factors and therapeutic targets for GC.

4070 Background: TOPAZ-1 (NCT03875235) is a randomized, double-blind, global, Phase 3 study evaluating the efficacy and safety of durvalumab (D) in combination with (+) gemcitabine and cisplatin (GC) as first-line treatment for patients (pts) with advanced biliary tract cancer (BTC).1 D + GC significantly improved overall survival (OS) versus placebo (PBO) + GC and represents a new treatment option. Methods: A pre-planned secondary objective of TOPAZ-1 was to assess pt-reported outcomes (PROs) for pts receiving D + GC versus PBO + GC. Pts with BTC were randomized 1:1 to D (1500 mg) or PBO, + G (1000 mg/m2) and C (25 mg/m2), for up to 8 cycles, followed by D or PBO monotherapy until disease progression, unacceptable toxicity, or other discontinuation criteria were met. PROs were assessed with the European Organisation for Research and Treatment of Cancer 30-item Quality of Life (QoL) Questionnaire, EORTC QLQ-C30 (C30), and the BTC 21-item module, EORTC QLQ-BIL21 (BIL21). Time to deterioration (TTD) was the primary assessment of PROs; defined as the time from randomization to the date of the first pre-specified, clinically meaningful deterioration (e.g. disease progression). The PRO analysis set included all pts from the full analysis set who completed a questionnaire. Results: Compliance rates for PROs were high at baseline (>81%) and remained high (majority >70% over 28 cycles) for both treatment groups. Baseline scores were comparable between treatment groups. Addition of D was well tolerated, with no significant difference in TTD in D + GC versus PBO + GC for pt-reported symptoms or functioning using either C30 or BIL21 (Table), or Global Health Status/QoL (hazard ratio [HR], 0.87; 95% confidence interval [CI], 0.69–1.12; p=0.279). Conclusions: Addition of D to GC improved OS (Oh D-Y, et al. J Clin Oncol 2022;40(suppl 4). Abs 378) and was well tolerated with no difference in TTD of QoL for pts, supporting D + GC as a new treatment option for pts with BTC. Clinical trial information: NCT03875235. [Table: see text]

[This corrects the article DOI: 10.3389/fonc.2020.591698.].