Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2024; 16(9): 3905-3912
Published online Sep 15, 2024. doi: 10.4251/wjgo.v16.i9.3905
Impact of oxaliplatin and trastuzumab combination therapy on tumor markers and T lymphocyte subsets for advanced gastric cancer
Cheng-Wan Zheng, Yun-Mo Yang, Hui Yang
Cheng-Wan Zheng, Yun-Mo Yang, Hui Yang, Department of Thyroid Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Co-first authors: Cheng-Wan Zheng and Yun-Mo Yang.
Author contributions: Zheng CW was the guarantor and designed the study; Zheng CW and Yang YM participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Yang H revised the article critically for important intellectual content; all authors participated in this study and jointly reviewed and edited the manuscript. Zheng CW and Yang YM, as the first authors, made equal contributions to this work. After discussion among all authors, it has been decided to designate Zheng CW and Yang YM as the first authors for three main reasons. Firstly, this study was conducted as a collaborative effort, and it is reasonable to designate a joint first author. The author accurately reflects the distribution of responsibilities and burdens related to the time and effort required to complete the research and final manuscript. Designating two co first authors will ensure effective communication and management of post submission matters, thereby improving the quality and reliability of the paper. It also promotes the most comprehensive and in-depth exploration of research topics, ultimately enriching readers' understanding by providing various expert perspectives. Thirdly, Zheng CW and Yang YM made substantial and equal contributions throughout the entire research process. Choosing these researchers as co first authors, acknowledging and respecting their equal contributions, demonstrates the spirit of collaboration and teamwork in this study. We believe that designating Zheng CW and Yang YM as co first authors is suitable for our manuscript, as it accurately reflects the collaborative spirit.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Southwest Medical University.
Clinical trial registration statement: This study is registered at the Clinical Registry. https://www.researchregistry.com (Researchregistry10314).
Informed consent statement: The study has obtained the consent of patients and guardians, and an informed consent form has been signed.
Conflict-of-interest statement: We all authors jointly declare that there is no conflict of interest disclosure relationship.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui Yang, MMed, Chief Physician, Department of Thyroid Surgery, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou 646000, Sichuan Province, China. yh65011@163.com
Received: June 5, 2024
Revised: July 3, 2024
Accepted: July 9, 2024
Published online: September 15, 2024
Processing time: 95 Days and 21.6 Hours
Abstract
BACKGROUND

Advanced gastric cancer (AGC) remains a challenging malignancy with poor prognosis. The combination of oxaliplatin and trastuzumab has shown promising results in AGC treatment. This study aimed to investigate the effects of oxaliplatin and trastuzumab combination therapy on serum tumor markers and T lymphocyte subsets in patients with AGC and to explore their potential as predictive biomarkers for treatment response.

AIM

To investigate the impact of oxaliplatin and trastuzumab combination therapy on serum markers and T cell subsets in patients with AGC.

METHODS

This prospective study enrolled 60 patients with AGC. All patients received oxaliplatin (130 mg/m2, every 3 weeks) and trastuzumab (8 mg/kg loading dose, followed by 6 mg/kg every 3 weeks) for six cycles. Serum carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), and cancer antigen 72-4 (CA72-4) were measured before and after treatment. T-lymphocyte subsets, including CD3+, CD4+, CD8+, and CD4+ /CD8+ ratios, were also evaluated. The clinical response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1.

RESULTS

After six cycles of treatment, the CEA, CA19-9, and CA72-4 serum levels significantly decreased compared to baseline levels (P < 0.001). The percentages of CD3+ and CD4+ T lymphocytes increased significantly (P < 0.05), whereas the percentage of CD8+ T lymphocytes decreased (P < 0.05). The CD4+/CD8+ ratio also significantly increased after treatment (P < 0.05). Patients with a higher decrease in serum tumor markers (≥ 50% reduction) and a higher increase in CD4+/CD8+ ratio (≥ 1.5-fold) showed better clinical response rates (P < 0.05).

CONCLUSION

Oxaliplatin and trastuzumab combination therapy effectively reduced serum tumor marker levels and modulated T lymphocyte subsets in patients with AGC. Combination therapy not only has a direct antitumor effect, but also enhances the immune response in patients with AGC. Serum tumor markers and T lymphocyte subsets may serve as potential predictive biomarkers for treatment response in patients with AGC receiving combination therapy.

Keywords: Advanced gastric cancer; Oxaliplatin; Trastuzumab; Serum tumor markers; T lymphocyte subsets; Predictive biomarkers

Core Tip: An investigation of the effects of oxaliplatin and trastuzumab combination therapy on serum tumor markers and T lymphocyte subsets in patients with advanced gastric cancer (AGC) revealed significant reductions in carcinoembryonic antigen, cancer antigen 19-9, and cancer antigen 72-4 levels, as well as favorable changes in T cell populations. Patients with significantly decreased tumor marker levels and increased CD4+/CD8+ ratio exhibited better treatment responses. The therapy not only targets tumors but also boosts immune responses in patients with AGC. Serum markers and T cell subsets are potential predictive biomarkers for treatment outcomes in patients with AGC receiving this combined treatment.