Metabolic Heterogeneity Affects Trastuzumab Response and Survival in HER2-positive Advanced Gastric Cancer

Overview

Journal Br J Cancer

Specialty Oncology

Date 2024 Jan 24

PMID 38267634

Authors

Jun Wang

Na Sun

Thomas Kunzke

Jian Shen

Annette Feuchtinger

Qian Wang

Raphael Meixner

Ronan Le Gleut

Ivonne Haffner

Birgit Luber

Florian Lordick

Axel Walch

Affiliations

Soon will be listed here.

Abstract

Background: Trastuzumab is the only first-line treatment targeted against the human epidermal growth factor receptor 2 (HER2) approved for patients with HER2-positive advanced gastric cancer. The impact of metabolic heterogeneity on trastuzumab treatment efficacy remains unclear.

Methods: Spatial metabolomics via high mass resolution imaging mass spectrometry was performed in pretherapeutic biopsies of patients with HER2-positive advanced gastric cancer in a prospective multicentre observational study. The mass spectra, representing the metabolic heterogeneity within tumour areas, were grouped by K-means clustering algorithm. Simpson's diversity index was applied to compare the metabolic heterogeneity level of individual patients.

Results: Clustering analysis revealed metabolic heterogeneity in HER2-positive gastric cancer patients and uncovered nine tumour subpopulations. High metabolic heterogeneity was shown as a factor indicating sensitivity to trastuzumab (p = 0.008) and favourable prognosis at trend level. Two of the nine tumour subpopulations associated with favourable prognosis and trastuzumab sensitivity, and one subpopulation associated with poor prognosis and trastuzumab resistance.

Conclusions: This work revealed that tumour metabolic heterogeneity associated with prognosis and trastuzumab response based on tissue metabolomics of HER2-positive gastric cancer. Tumour metabolic subpopulations may provide an association with trastuzumab therapy efficacy.

Clinical Trial Registration: The patient cohort was conducted from a multicentre observational study (VARIANZ;NCT02305043).

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