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Clinicopathological significance and immunotherapeutic outcome of claudin 18.2 expression in advanced gastric cancer:A retrospective study

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Chinese Journal of Cancer Research 2024年第1期36卷 78-89页

作者： Changsong Qi Xiaoyi Chong Ting Zhou Mingyang Ma jifang gong Miao Zhang Jian Li Jun Xiao Xiaohui Peng Zhen Liu Zonghai Li Lin Shen Xiaotian Zhang State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers Beijing Key Laboratory of Carcinogenesis and Translational ResearchDepartment of Gastrointestinal OncologyPeking University Cancer Hospital&InstituteBeijing 100142China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of Gastrointestinal OncologyPeking University Cancer Hospital&InstituteBeijing 100142China CARsgen Therapeutics Co. LtdShanghai 200231China CARsgen Life Sciences Co. LtdShanghai 200131China

Objective: Immunotherapeutic outcomes and clinical characteristics of claudin 18 isoform 2 positive(CLDN18.2-positive) gastric cancer(GC) vary in different clinical studies, making it difficult to optimize antiCLDN18.2 therapy. We conducted a retrospective analysis to explore the association of CLDN18.2 expression with clinicopathological characteristics and immunotherapeutic outcomes in ***: A total of 536 advanced GC patients from 2019 to 2021 in the CT041-CG4006 and CT041-ST-01clinical trials were included in the analysis. CLDN18.2 expression on ≥40% of tumor cells(2+, 40%) and CLDN18.2 expression on ≥70% of tumor cells(2+, 70%) were considered the two levels of positively expressed GC. The clinicopathological characteristics and immunotherapy outcomes of GC patients were analyzed according to CLDN18.2 expression ***: CLDN18.2 was expressed in 57.6%(cut-off: 2+, 40%) and 48.9%(cut-off: 2+, 70%) of *** death-ligand 1(PD-L1) and CLDN18.2 were co-expressed in 19.8% [combined positive score(CPS)≥1, CLDN18.2(cut-off: 2+, 40%)] and 17.2% [CPS≥5, CLDN18.2(cut-off: 2+, 70%)] of ***18.2 expression positively correlated with younger age, female sex, non-gastroesophageal junction(nonGEJ), and diffuse phenotype(P<0.001). HER2 and PD-L1 expression were significantly lower in CLDN18.2-positive GC(both P<0.05). Uterine adnexa metastasis(P<0.001) was more frequent and liver metastasis(P<0.001)was less common in CLDN18.2-positive GC. Overall survival and immunotherapy-related progression-free survival(ir PFS) were inferior in the CLDN18.2-positive ***: CLDN18.2-positive GC is associated with poor prognosis and worse immunotherapeutic outcomes. The combination of anti-CLDN18.2 therapy, anti-PD-L1/PD-1 therapy, and chemotherapy for GC requires further investigation.

关键词： Gastric cancer claudin18.2 CT041 PD-L1 immunotherapy

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Clinical efficacy and identification of factors confer resistance to afatinib(tyrosine kinase inhibitor)in EGFR-overexpressing esophageal squamous cell carcinoma

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Signal Transduction and Targeted Therapy 2024年第7期9卷 3130-3140页

作者： Yanni Wang Chang Liu Huan Chen Xi Jiao Yujiao Wang Yanshuo Cao Jian Li Xiaotian Zhang Yu Sun Na Zhuo Fengxiao Dong Mengting Gao Fengyuan Wang Liyuan Dong jifang gong Tianqi Sun Wei Zhu Henghui Zhang Lin Shen Zhihao Lu Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of Gastrointestinal OncologyPeking University Cancer Hospital and InstituteBeijingChina Genecast Biotechnology Co. LtdWuxiPR China State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers Beijing Key Laboratory of Carcinogenesis and Translational ResearchDepartment of Gastrointestinal OncologyPeking University Cancer Hospital and InstituteBeijingChina Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education) Department of PathologyPeking University Cancer Hospital and InstituteBeijingChina Precision Scientific(Beijing)Co. Ltd.BeijingChina Generulor Company Bio-X Lab ZhuhaiGuangdongChina Biomedical Innovation Center Beijing Shijitan HospitalCapital Medical UniversityBeijingChina Beijing Key Laboratory for Therapeutic Cancer Vaccines Beijing Shijitan HospitalCapital Medical UniversityBeijingChina

Epidermal growth factor receptor(EGFR)is reportedly overexpressed in most esophageal squamous cell carcinoma(ESCC)patients,but anti-EGFR treatments offer limited survival *** preclinical data showed the promising antitumor activity of afatinib in EGFR-overexpressing *** proof-of-concept,phase II trial assessed the efficacy and safety of afatinib in pretreated metastatic ESCC patients(n=41)with EGFR overexpression(NCT03940976).The study met its primary endpoint,with a confirmed objective response rate(ORR)of 39%in 38 efficacy-evaluable patients and a median overall survival of 7.8 months,with a manageable toxicity *** analysis of pretreatment tumors revealed that neurotrophic receptor tyrosine kinase 2(NTRK2)was negatively associated with afatinib sensitivity and might serve as a predictive biomarker,irrespective of EGFR ***,knocking down or inhibiting NTRK2 sensitized ESCC cells to afatinib *** study provides novel findings on the molecular factors underlying afatinib resistance and indicates that afatinib has the potential to become an important treatment for metastatic ESCC patients.

关键词： esophageal squamous expressing

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Clinical study of ultrasound and microbubbles for enhancing chemotherapeutic sensitivity of malignant tumors in digestive system

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Chinese Journal of Cancer Research 2018年第5期30卷 553-563页

作者： Yanjie Wang Yan Li Kun Yan Lin Shen Wei Yang jifang gong Ke Ding Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Ultrasound Peking University Cancer Hospital & Institute Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Gastrointestinal Oncology Peking University Cancer Hospital & Institute

Objective： To explore the safety of ultrasound and microbubbles for enhancing the chemotherapeutic sensitivity of malignant tumors in the digestive system in a clinical trial, as well as its ***： From October 2014 to June 2016, twelve patients volunteered to participate in this study. Eleven patients had hepatic metastases from tumors of the digestive system, and one patient had pancreatic carcinoma. According to the mechanical index （MI） in the ultrasound field, patients were classified into four groups with MIs of 0.4, 0.6, 0.8 and 1.0. Within half an hour after chemotherapy, patients underwent ultrasound scanning with ultrasound microbubbles （SonoVue） to enhance the efficacy of chemotherapy. All adverse reactions were recorded and were classified in 4 grades according to the Common Terminology Criteria for Adverse Events version 4.03 （CTCAE V4.03）. Tumor responses were evaluated by the Response Evaluation Criteria in Solid Tumors version 1.1 criteria. All the patients were followed up until ***： All the adverse reactions recorded were level 1 or level 2. No local pain occurred in any of the patients. Among all the adverse reactions, fever might be related to the treatment with ultrasound combined with microbubbles. Six patients had stable disease （SD）, and one patient had a partial response （PR） after the first cycle of treatment. At the end of follow-up, tumor progression was restricted to the original sites, and no new lesions had ***： Our preliminary data showed the potential role of a combined treatment with ultrasound and microbubbles in enhancing the chemotherapeutic sensitivity of malignant tumors of the digestive system. This technique is safe when the MI is no greater than 1.0.

关键词： Clinical study sonoporation microbubbles chemotherapy digestive system

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Clinicopathologic features and treatment efficacy of Chinese patients with BRAF-mutated metastatic colorectal cancer: a retrospective observational study

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Chinese Journal of Cancer 2017年第11期36卷 626-634页

作者： Xicheng Wang Qing Wei Jing Gao Jian Li Jie Li jifang gong Yanyan Li Lin Shen Department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education) Peking University Cancer Hospital & Institute Beijing 100142 P. R. China

Background: The prognostic role of the V600 E mutation of v-raf murine sarcoma viral oncogene homolog B1(BRAF)in metastatic colorectal cancer(mCRC) is well established, but the therapeutic regimen targeting this disease is lacking. This study aimed to analyze the clinicopathologic features of and treatment efficacy of commonly used regimens on BRAF-mutated ***: We collected and reviewed the medical records of mCRC patients treated at Peking University Cancer Hospital & Institute(Beijing, China) between July 2011 and July 2016. Kirsten rat sarcoma viral oncogene homolog(KRAS),neuroblastoma RAS viral oncogene homolog(NRAS), and BRAF mutational status was assayed using direct sequencing. The details of clinicopathologic characteristics of patients and their responses to FOLFOXIRI regimen or standard therapy were obtained by reviewing the medical records. The progression-free survival(PFS) and overall survival(OS)were assessed using Kaplan-Meier analysis and compared using the log-rank ***: Of 1694 patients studied, 75 had BRAF exon 15 mutations. Of these 75 patients, 71 had V600 E mutation, 1 had D594 G mutation, 2 had K601 E mutation, and 1 had a novel T599_V600 insAGA alteration. No patients had KRAS or NRAS mutations. Of 63 patients with BRAFV600 E-mutated mCRC and sufficient clinical data, 27(42.9%) had right-sided colon tumors, 19(30.2%) had left-sided colon tumors, and 17(26.9%) had rectal tumors; 26(41.3%) had peritoneal metastases, and 50(79.4%) had distant lymph node *** patients with BRAF K601 E-and T599_V600 insAGA-mutated tumors had similar clinicopathologic features to those with BRAFV600 E-mutated tumors. Patients with the BRAFV600 E mutation benefited more from FOLFOXIRI regimen compared with patients who underwent standard therapy(overall response rate 83.3% vs. 14.0%; median PFS 6.4 months vs. 2.8 months, P = 0.220; median OS11.0 months vs. 6.9 months, P = 0.048).Conclusions: BRAFV600 E mutations were commonly identified i

关键词： Colorectal cancer BRAF Chemotherapy Prognosis

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奥沙利铂对照顺铂治疗进展期胃癌的荟萃分析

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中华医学杂志 2009年第46期89卷 3261-3265页

作者：龚继芳沈琳北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室消化肿瘤内科北京100142

目的系统分析奥沙利铂治疗进展期胃癌的疗效和安全性以及应用前景。方法通过检索中国数字化期刊全文数据库（CNKI）、万方数据库、维普全文网、美国国家医学图书馆查询系统（PubMed）中近6年来国内外公开发表的文献，收集以奥沙利铂为... 详细信息

目的系统分析奥沙利铂治疗进展期胃癌的疗效和安全性以及应用前景。方法通过检索中国数字化期刊全文数据库（CNKI）、万方数据库、维普全文网、美国国家医学图书馆查询系统（PubMed）中近6年来国内外公开发表的文献，收集以奥沙利铂为主的联合方案（试验组）对照顺铂联合方案（对照组）治疗进展期胃癌的临床试验数据，联合药物限定为氟尿嘧啶类（包括卡培他滨）和（或）表阿霉素。使用Review Manager4.2进行有效率、1年生存率、不良反应等方面的荟萃分析。结果共16篇文献入选，总计2121例胃癌患者，其中试验组1062例，对照组1059例。奥沙利铂为主的联合方案组的有效率（46.3％）较顺铂组（40.6％）高（OR=1.28，P=0.006），1年生存率也高（44.6％比39.3％，OR=1.25，P=0.04）；而不良反应中试验组的周围神经毒性的发生率高于对照组（70.6％比21.9％，OR=10.76，P〈0.01），贫血（58.0％比70.1％，OR=1.65）和恶心呕吐（61.4％比75.6％，OR：1.32）的发生率则低，差异均有统计学意义（均P〈0.05）。结论与既往的顺铂为主的方案相比，奥沙利铂为主的化疗方案在治疗进展期胃癌方面有更好的疗效，相对较安全，患者更易耐受。

关键词：胃肿瘤抗肿瘤联合化疗方案顺铂奥沙利铂

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Alterations in DNA damage response and repair genes as potential biomarkers for immune checkpoint blockade in gastrointestinal cancer

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Cancer Biology & Medicine 2022年第8期19卷 1139-1149页

作者： Yujiao Wang Xi Jiao Shuang Li Huan Chen Xin Wei Chang Liu jifang gong Xiaotian Zhang Xicheng Wang Zhi Peng Changsong Qi Zhenghang Wang Yanni Wang Na Zhuo Jianling Zou Henghui Zhang Jian Li Lin Shen Zhihao Lu Department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Peking University Cancer Hospital&InstituteBeijing 100142China Department of Gastric&Colorectal Surgery The First Hospital of Jilin UniversityChangchun 130021China Genecast Precision Medicine Technology Institute Beijing 100192China Life Sciences Institute Zhejiang UniversityHangzhou 310058China Institute of Infectious Diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China

Objective:Immune checkpoint inhibitors(ICIs)have achieved remarkable results in cancer ***,there is no effective predictive biomarker for gastrointestinal(GI)***:We conducted integrative analyses of the genomic and survival data of ICI-treated GI cancer patients from the Memorial Sloan Kettering Cancer Center cohort(MSK-GI,n=227),the Janjigian cohort(n=40),and the Peking University Cancer Hospital&Institute cohort(PUCH,n=80)to determine the possible associations between DNA damage response and repair(DDR)gene mutations and clinical *** from The Cancer Genome Atlas database were analyzed to determine the possible correlations between DDR gene mutations and the tumor ***:In the MSK cohort,the presence of≥2 DDR gene mutations was correlated with prolonged overall survival(OS).The Janjigian and PUCH cohorts further confirmed that subgroups with≥2 DDR gene mutations displayed a prolonged OS and a higher durable clinical ***,the DDR gene mutation load could be considered as an independent prognostic factor,and exhibited a potential predictive value for survival in GI cancer patients treated with ***,we showed that the presence of≥2 DDR gene mutations was correlated with higher levels of tumor mutation burden,neoantigen,and T cell ***:The DDR gene mutation status was correlated with favorable clinical outcomes in GI cancer patients receiving ICIs,which could serve as a potential biomarker to guide patient selection for immunotherapy.

关键词： Gastrointestinal cancer DDR gene mutation immunotherapy biomarker

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Aneuploidy of chromosome 8 in circulating tumor cells correlates with prognosis in patients with advanced gastric cancer

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Chinese Journal of Cancer Research 2016年第6期28卷 579-588页

作者： Yilin Li Xiaotian Zhang jifang gong Qiyue Zhang Jing Gao Yanshuo Cao Daisy Dandan Wang Peter Ping Lin Lin Shen Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Gastrointestinal Oncology Peking University Cancer Hospital & Institute Cytelligen San Diego

Objective： Previous work indicated that aneuploidy of chromosome 8 in circulating tumor cells（CTCs）correlated with therapeutic efficacy for advanced gastric cancer（AGC） patients. In this follow-up study performed on the same population of AGC patients, we investigated whether and how aneuploidy of chromosome 8 in CTCs correlates with patients＇ clinical ***： The prospective study was performed on 31 patients with newly diagnosed AGC. Previously established integrated subtraction enrichment（SE） and immunostaining-fluorescence in situ hybridization（i FISH）platform was applied to identify, enumerate and characterize CTCs. Quantification of CTCs and analysis of their aneuploidy of chromosome 8 were performed on patients before and after ***： CTCs were measured in 93.5% of AGC patients, and two CTC subtypes with diverse threshold values were identified, multiploid CTCs with the threshold of ≥2 per 7.5 m L and multiploid plus triploid CTCs with the threshold of ≥4, which were found to significantly correlate with poor progression-free survival（PFS） and overall survival（OS）. In particular, patients with ≥10% increased multiploid CTCs after an initial 6 weeks of therapy had poor PFS and OS, whereas improved PFS and OS were observed on those who had ≥10% decreased multiploid CTCs. After adjusting for clinically significant factors, ≥10% increased post-therapy multiploid CTCs was the only independent predictor of PFS and ***： Aneuploidy of CTCs correlates with prognosis of AGC patients. Quantitative comparison monitoring multiploid CTCs before and after therapy may help predict improved or inferior prognosis and chemoresistance.

关键词： Circulating tumor cells advanced gastric cancer aneuploidy i FISH prognosis

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Recombinant human interleukin-11 for treatment of chemotherapy-induced thrombocytopenia in patients with gastrointestinal cancer

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The Chinese-German Journal of Clinical Oncology 2007年第5期6卷 450-452页

作者： Jie Li Lin Shen Yan Li Xiaodong Zhang Jian Li jifang gong Wei Deng Department of Gastrointestinal Oncology Peking University School of Oncology Beijing Cancer Hospital ＆ Institute Bejing 100036 China

Objective： To evaluate the efficacy and safety of recombinant human interleukin-11 （rhIL-11） for the chemotherapy-induced thrombocytopenia in patients with gastrointestinal cancer. Methods： It was an opened and non-randomized controlled clinical study. When the platelet counts was under 75 × 10^9/L after chemotherapy, rhlL-11 was administered 25 μg/（kg·d） as a daily SC injection last for 7-14 days, or discontinued when platelet counts 〉 100 × 10^9/L. Results： Seventysix patients were enrolled into this study. The treatment group and the control group had thirty-eight cases, respectively. The mean recovery time to PLT ≥ 100 × 10^9/L was 8.1 days in treatment group, while in control group was 12.2 days （P 〈 0.01）. Moreover, the mean recovery time from PLT 〈_ 50 × 10^9/L to 〉 100 × 10^9/L was 8.9 days in treatment group, while in control group was 12.9 days （P 〈 0.05）. There was a statistical difference between the two groups. Major side effects included edema, fever, articular muscle soreness, but they were all mild and well tolerable. Conclusion： rhIL-11 can be safely and effectively used for the treatment of chemotherapy-induced thrombocytopenia in patients with gastrointestinal cancer.

关键词： recombinant human interleukin-11 (rhIL-11) gastrointestinal cancer thrembocytopenia chemotherapy

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146例胃癌骨转移患者特征及预后因子的单中心分析

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中国肿瘤临床 2017年第12期44卷 594-599页

作者：寇芙蓉陆明龚继芳沈琳北京大学肿瘤医院暨北京市肿瘤防治研究所消化肿瘤内科恶性肿瘤发病机制及转化研究教育部重点实验室北京市100142

目的:研究胃癌骨转移患者的临床特征、治疗模式及预后因子。方法:收集1996年12月至2014年12月北京肿瘤医院收治的146例胃癌骨转移患者临床资料,进行单因素和多因素生存分析。结果:所有患者中,51例(34.9%)为同时性骨转移,95例为(65.1%)... 详细信息

目的:研究胃癌骨转移患者的临床特征、治疗模式及预后因子。方法:收集1996年12月至2014年12月北京肿瘤医院收治的146例胃癌骨转移患者临床资料,进行单因素和多因素生存分析。结果:所有患者中,51例(34.9%)为同时性骨转移,95例为(65.1%)异时性骨转移。35例(24.0%)患者以骨转移为唯一远处转移灶;111例(76.0%)合并其他部位转移,包括肝(30.0%)、腹膜(24.0%)、肺(15.1%)和骨髓(7.5%)。发生骨转移后,99例(67.8%)患者接受双膦酸盐治疗,34例(23.3%)行骨放疗,5例(3.4%)行骨手术;此外,96例(65.6%)患者接受全身化疗。骨转移后患者的中位生存时间(median overall survival,mOS)为5.8个月(95%CI:4.284~7.316)。多因素分析显示KPS<80分(P=0.030)、存在骨髓转移(P<0.001)、骨转移后未全身化疗(P<0.001)、糖类抗原199(carbohydrate antigen 199,CA199)升高(P<0.001)是独立的不良预后因子。结论:胃癌骨转移患者预后差,生存期短,尤其是合并骨髓转移、KPS评分较差及CA199升高者,发生骨转移后给予全身化疗可能给患者带来生存获益。

关键词：胃癌骨转移临床特征治疗模式预后因子

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外周血循环肿瘤细胞及人表皮生长因子受体2胞外区表达在进展期胃癌治疗疗效评估中的价值

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中华胃肠外科杂志 2017年第11期20卷 1293-1299页

作者：李一林彭智张小田龚继芳沈琳北京大学肿瘤医院暨北京市肿瘤防治研究所消化肿瘤内科恶性肿瘤发病机制及转化研究教育部重点实验室100142

目的研究人血清中表皮生长因子受体2胞外区（HER2 ECD）与外周血循环肿瘤细胞（CTC）的相关性，并进一步研究组织学HER2阴性或阳性胃癌患者中，HER2 ECD动态变化及与治疗疗效的关系。方法将北京大学肿瘤医院消化肿瘤内科2012年1月至2014... 详细信息

目的研究人血清中表皮生长因子受体2胞外区（HER2 ECD）与外周血循环肿瘤细胞（CTC）的相关性，并进一步研究组织学HER2阴性或阳性胃癌患者中，HER2 ECD动态变化及与治疗疗效的关系。方法将北京大学肿瘤医院消化肿瘤内科2012年1月至2014年1月期间收治、并曾入组中国进展期胃癌CTC临床研究（ClinicalTrial gov. ID：NCT01625702）的53例患者入组本回顾性研究。入组条件：除病理组织学确诊为进展期胃癌外，至少接受2个周期以氟尿嘧啶为基础的化疗或联合靶向治疗，并同时进行了治疗前后外周血CTC的计数；按实体瘤的疗效评价标准（RECIST），治疗前至少具有一个可测量的靶病灶；患者需经医院伦理委员会同意及患者知情同意。留取患者治疗前及治疗2周期后的血清，利用化学发光免疫分析法进行血清样本中HER2 ECD水平的检测。HER2 ECD阳性阈值为≥15 ng/ml；CTC计数阳性阈值为≥3个/7.5 ml。采用Log-rank检验不同组间无进展生存期（PFS）及总体生存期（OS）的差异。结果53例进展期胃癌患者HER2阴性39例，HER2阳性的9例（17.0%），另5例检测状态未知。均接受氟尿嘧啶为基础的化疗，9例HER2阳性患者在化疗基础上联合抗HER2靶向治疗。治疗前全组血清HER2 ECD中位浓度为10.45（8.0-83.2）ng/ml；HER2 ECD阳性7例（13.2%），其中4例为HER2阳性患者外，3例HER2阴性患者同样存在血清HER2 ECD阳性；CTC中位数为2（0-668）个/7.5 ml，CTC阳性25例（47.2%）。HER2阴性患者中有10例治疗后血清HER2 ECD阳性，其中有2例患者在治疗前其HER2 ECD分别为83.3 ng/ml和46.9 ng/ml，治疗后则为22.4 ng/ml和20.4 ng/ml；另8例治疗前HER2 ECD均〈15 ng/ml（10.3-14.5 ng/ml），但在治疗2个周期后发生获得性HER2 ECD水平升高（15.1-19.5 ng/ml）。治疗后血清HER2 ECD水平升高患者外周血CTC水平通常较低，但相关性未达统计学差异。HER2阴性病例，治疗前血清HER2 ECD阳性患者与HER2 ECD阴性患者的PFS（7.6月比4.4月，P = 0.328）及OS（13.6比10.9，P = 0.679）比较，差异无统计学意义。HER2阳性病例，治疗前HER2 ECD阳性者其PFS（10.7月）和OS（16.5月）均显著长于HER2 ECD阴性者（4.2月和8.9月），差异有统计学意义（P = 0.025，P = 0.015）。HER2阴性病例，治疗前CTC计数阴性者PFS和OS（5.3月和14.3月）显著长于CTC计数阳性患者（3.3月和7.6月），差异有统计学意义（P = 0.049，P = 0.001）。而HER2阳性者，CTC计数多少均与PFS及OS无关（均P 〉 0.05）。HER2阴性的8例治疗2周期后发生获得性HER2 ECD水平升高者，其HER2 ECD水平升高与PFS及OS无关（P 〉 0.05）。9例HER2阳性患者，4例治疗后HER2 ECD水平下降、CTC计数下降或不变者，其PFS（7.5-15.3月）和OS（11.0-26.3月），长于治疗后HER2 ECD水平上升的2例患者，其PFS分别为3.0和4.8月，OS则分别为7.3和8.6月。结论HER2阳性胃癌患者治疗前HER2 ECD水平升高预示更好的PFS及OS，且治疗过程中HER2 ECD获得性升高预示疗效不佳。HER2 ECD水平可在HER2阴性患者中获得性升高，且与外周血CTC计数水平变化存在相关性。

关键词：胃肿瘤进展期液体活检循环肿瘤细胞人表皮生长因子受体2胞外区疗效评估

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