Xüe-Feng Zhao

Prevalence of Th17 and Treg cells in gastric cancer patients and its correlation with clinical parameters.

Th17 cells and CD4+CD25+ regulatory T (Treg) cells have been reported to share reciprocal developmental pathways but exhibit opposite effects, and the balance between them controls inflammation and autoimmune diseases. However, information regarding Th17/Treg cells in cancer-bearing hosts is still limited. In the present study, we investigated the distribution of Th17 cells in relation to Treg cells in gastric cancer patients, and evaluated how the imbalance in Th17/Treg cells in gastric cancer correlates with clinical and pathological parameters. We observed that the accumulation of Th17 and Treg cells in the tumor microenvironment was gradually increased according to disease progression, leading to an imbalance in Th17/Treg cells in gastric cancer patients. TGF-β and interleukin (IL)‑6 present in the gastric cancer microenvironment promoted the differentiation and expansion of Th17 cells, and increased numbers of Th17 cells promoted tumor progression through promotion of inflammation by secretion of IL-17. Treg cells promoted tumor progression by helping cancer cells escape from host immunosurveillance by secreting TGF-β, and a high level of TGF-β in the tumor microenvironment promoted differentiation and expansion of Treg cells. In conclusion, the imbalance in Th17/Treg cells was involved in the development and progression of gastric cancer. A better understanding of the nature, regulation, and function of Th17 and Treg cells in tumor immunity may aid in the development of novel and effective immunotherapy for gastric cancer.

Gastrointestinal stromal tumor (gist) with liver metastases: An 18-year experience from the Gist cooperation group in North China

Abstract Approximately 40% to 50% of gastrointestinal stromal tumor (GIST) patients will have recurrence or metastases after resection of the primary lesion, and the most common affected sites will be liver and peritoneum. Imatinib has been considered as the first-line therapy of metastatic GIST. Surgery for metastases is proposed when possible. Furthermore, there are controversies concerning hepatic resection and systemic tyrosin kinase inhibitors (TKIs). The therapeutic conditions and long-term outcome of GIST patients with liver metastases in northern China remain unknown. The clinical, pathological, and follow-up data of 144 GIST patients, who had liver metastases between June 1996 and June 2014 from 3 tertiary cancer centers in northern China, were reviewed. Thirty-two cases (22.2%) had hepatectomy with 23 (23/32, 71.9%) R0 resections and 9 (9/32, 28.1%) R1/R2 resections, respectively. Twenty-three patients were given imatinib postoperatively. Furthermore, 98 (68.1%) patients were given TKIs only to control disease progression, and sunitinib was considered after imatinib failure in 12 patients. The 1-, 3- and 5-year survival rate was 82%, 51%, and 24%, with a median overall survival of 48 months for all patients. Patients who had hepatic resection combined with TKIs had a tendency of improved outcome, and the median survival time was 89 months. This was in contrast to patients who received TKIs only, in which median survival time was 53 months. Patients who received imatinib plus sunitinib had a tendency of longer survival time, compared with patients who received imatinib only (not reached vs 50 months). TKIs combined with hepatic resection had a role in improving the outcome of GIST patients with liver metastases.

630PCONCURRENT NEOADJUVANT CHEMORADIOTHERAPY FOR SIEWERT II AND III ADENOCARCINOMA OF THE GASTROESOPHAGEAL JUNCTION: SHORT TERM EFFICACY

ABSTRACT Aim: This study was conducted to investigate the efficacy and safety of applying concurrent neoadjuvant chemoradiotherapy in treatment of adenocarcinoma of the gastroesophageal junction. Methods: From August 2012 to August 2013, a total of 76 patients with resectable adenocarcinoma of the gastroesophageal junction (T3/4,N + ,M0) were recruited and randomly assigned to a concurrent chemoradiotherapy group (n = 36) or a surgery group (n = 40). Patients in the chemoradiation group received oral administration of capecitabine (1000 mg/m2, bid, for 14 days), and intravenous administration of oxaliplatin (130 mg/m2 on day 1, q3w, for 2 courses). A total of 45 Gy radiations were administered during a period of 5 weeks (25 sessions). Patients in the surgery group received surgical intervention alone. This study was approved by the ethics committee and registered in ClinicalTrials.gov(NCT01962246). Results: In the concurrent chemoradiotherapy group, the overall response rate was 55.6% (20/36), the tumor control rate was 100%, and pathological complete response was achieved in 6 of 36 patients (16.7%). The proportion of patients who achieved R0 resection in the concurrent chemoradiotherapy group and surgery group was 100% and 80% (32/40), respectively (P Complications Concurrent chemoradiotherapy (n = 36) Surgery alone (n = 40) Lymphatic fistula 1 (27.8) 0 Pleural effusion and ascites 1 (27.8) 0 Esophageal-jejunal anastomotic fistula 0 1 (25) Wound dehiscence 0 1 (25) Conclusions: Administration of concurrent neoadjuvant chemoradiotherapy increased the rate of R0 resection and well tolerated in patients with Siewert II or III adenocarcinoma of the gastroesophageal junction. A phase III trial is planned to further proof this concept. Disclosure: All authors have declared no conflicts of interest.