Abstract 2758: Stemness subtype gastric cancer accelerate hematogenous metastasis

Abstract Oncogenic progression and metastasis correlate with the acquisition of stem cell-like characteristics and the loss of differentiated phenotype. Poorly differentiated primary tumors often lead to unfavorable oncologic outcomes due to a heightened likelihood of metastasis to distant organs across various cancers. However, the relationship between stemness traits and metastasis in gastric cancer (GC) remains insufficiently explored. In this investigation, we analyzed bulk RNA-sequencing from microdissected primary tumor specimens and clinical data to pinpoint molecular subtypes linked to distant organ metastasis. Transcriptomic data from patient-derived xenograft (PDX) samples and available single-cell RNA datasets validated our bulk RNAseq findings. Comprehensive analysis highlighted the molecular traits of GC tied to hematogenous metastasis. Microdissection of primary tumor FFPE samples facilitated bulk RNA sequencing, encompassing samples from 33 metastatic and 31 metastasis-free patients, with 8 paired normal samples. Most samples contained less than 10% of tumor microenvironment (TME) components like fibroblasts, endothelial cells, and immune cells. Using non-negative matrix factorization (NMF) clustering, we achieved unsupervised subtyping of the gastric cancer gene expression matrix. Permutation tests based on subsampling indicated consistent high-level cophenetic coefficients at k=2, suggesting robust bifurcation of transcriptomic data into two clusters. One showed augmented stemness traits while the other emphasized differentiated mucosal genes, labeled as stemness and differentiated subtypes, respectively. GSEA highlighted a significant boost in the Hallmark angiogenesis score in the stemness subtype, not attributed to endothelial cell infiltration as verified by CIBERSORTx. This subtype also exhibited a marked decrease in hematogenous metastasis-free survival (HMFS) (p=0.008, log-rank test). Further, PDX samples were scrutinized. Post classification of the PDX graft expression matrix via logistic regression, we examined the endothelial cell fraction, determined by CIBERSORTx. Stemness subtype PDX grafts revealed a significant elevation in the host (mouse) endothelial cell fraction (p<0.05). In addition, stemness PDX patient showed significant decreased HMFS (p = 0.03). We also categorized the pseudobulk expression matrix of malignant cells into stemness or differentiated subtypes using GSE183904 scRNA cohort. scRNA sample analysis consistently presented an elevated endothelial cell fraction in the stemness GC subtype. The outcomes suggest a propensity for angiogenesis in the TME of the stemness subtype of GC. In conclusion, our findings demonstrate that the stemness subtype of GC accelerates hematogenous metastasis, as evidenced through clinical data, bulk RNAseq, PDX, and scRNAseq data. Citation Format: Seungho Lee, Jaeun Yoo, Seungbok Lee, Hyun Myong Kim, Kyoungyun Jeong, Yie-Ri Yoo, Ji-Yeon Shin, Kyoung Un Park, Hye Seung Lee, Seong-Ho Kong, Do Joong Park, Hyuk-Joon Lee, Han-Kwang Yang. Stemness subtype gastric cancer accelerate hematogenous metastasis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2758.