![]() We have identified a 3-gene signature (EPHA5, BCL6, and ERBB2) that is predictive of response to neoadjuvant chemoradiotherapy and a separate prognostic 9-gene classifier that predicts survival outcomes. The sensitivity for this model was 73.33% and the specificity was 94.74%. ![]() Independently, a 9 gene signature was created using APC, MAP3K6, ETS1, CSF3R, PDGFRB, GATA2, ARID1A, PML, and FGF6, which significantly stratifies patients into risk categories, prognosticating for improved relapse-free ( p = 4.73E-03) and overall survival ( p = 3.325E-06). For this model, sensitivity was 84.6% and specificity was 100%. ResultsĪ 3-gene signature, based on mutations in EPHA5, BCL6, and ERBB2, was identified that robustly predicts response to the CROSS regimen. A univariate Cox proportional hazard regression was used to examine associations between gene mutation status and overall survival. Differentially mutated gene analysis between responders and non-responders of treatment was performed to determine predictors of response. Capture-based targeted sequencing was performed on the paired baseline and post-treatment samples. Thirty four patients with locally advanced esophageal adenocarcinoma were analyzed, of which 21 received a CROSS regimen with carboplatin, paclitaxel, and radiation. Risk stratification relies heavily on clinicopathologic features, particularly pathologic response, which is inadequate, therefore establishing the need for new and reliable biomarkers for risk stratification. For locally advanced patients, neoadjuvant chemoradiotherapy followed by surgery is the standard of care. Esophageal adenocarcinoma is a lethal disease.
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