RecruitingNCT07464470

Comparison of Molecular-Genetic Concordance of the Primary Tumor and Brain Metastases of Gastroesophageal Cancers

Comparison of Molecular-Genetic Concordance of the Primary Tumor and Brain Metastases of Gastroesophageal Cancers (GENCONCOR-2)


Sponsor

Blokhin's Russian Cancer Research Center

Enrollment

30 participants

Start Date

Apr 1, 2026

Study Type

OBSERVATIONAL

Conditions

Summary

GENCONCOR-2 is a translational research aimed to compare the molecular profile of primary tumors and their matched brain metastases in gastroesophageal cancers, including cancer of the esophagus, gastroesophageal junction, and stomach. The study is based on the previously established international GASTROBRAIN cohort (ClinicalTrials.gov ID: NCT07448493), which provides comprehensive clinicopathological and treatment data for over 230 patients. It will be conducted by retrospective analysis of paired samples of histological material (primary tumor and corresponding brain metastasis) with determination of HER2 expression status (IHC ± FISH), MSI status (IHC ± PCR), PD-L1 combined positive score (CPS), and CLDN18.2 expression status (IHC)


Eligibility

Min Age: 18 Years

Inclusion Criteria4

  • Men and women aged 18 years or older included in the GASTROBRAIN study with available clinicopathological and treatment data.
  • Histologically confirmed gastric adenocarcinoma, esophageal carcinoma (adenocarcinoma or squamous cell carcinoma), or gastroesophageal junction adenocarcinoma.
  • History of neurosurgical resection of brain metastases with available archival tissue material, and histological confirmation of metastatic lesion originating from gastroesophageal cancer.
  • Availability of paired FFPE tissue samples from primary tumor and matched brain metastasis.

Exclusion Criteria8

  • Synchronous or metachronous multiple primary malignancies involving sites other than the stomach, esophagus, or gastroesophageal junction.
  • Primary tumor located outside the gastrointestinal tract.
  • Histologically confirmed non-epithelial gastrointestinal malignancy (e.g., neuroendocrine tumors, sarcoma, gastrointestinal stromal tumor, lymphoma).
  • Intact brain parenchyma (e.g., metastases confined to skull bones or soft tissues of the head without brain parenchymal involvement).
  • Insufficient tumor material or poor sample quality for molecular analysis, defined as:
  • Tumor cell content \< 70% in the area of microdissection, or
  • Significant nucleic acid degradation compromising molecular testing
  • Missing one sample from a paired set (either primary tumor or brain metastasis unavailable).

Interventions

DIAGNOSTIC_TESTHER2 Testing

Assessment of HER2 status by immunohistochemistry (IHC) using SP3 antibody clone (DAKO) on Ventana GX platform with OptiView detection system. Cases with IHC 2+ will undergo confirmatory in situ hybridization (FISH, CISH, or SISH).

DIAGNOSTIC_TESTMSI Testing

Determination of microsatellite instability status by immunohistochemistry (IHC) for mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) ± PCR-based analysis using five mononucleotide repeat markers (BAT25, BAT26, NR21, NR24, NR27).

DIAGNOSTIC_TESTPD-L1 Testing

Assessment of PD-L1 expression by immunohistochemistry (IHC) using DAKO 22C3 antibody clone on Dako Link48 platform with EnVision Flex detection system. Results reported as Combined Positive Score (CPS), defined as number of PD-L1-stained cells divided by total viable tumor cells, multiplied by 100.

DIAGNOSTIC_TESTCLDN18.2 Testing

Assessment of CLDN18.2 expression by immunohistochemistry (IHC) using VENTANA CLDN18 (43-14A) assay on Ventana platform. Positive expression defined as moderate-to-strong (2+/3+) complete, basolateral, or lateral membranous staining in ≥ 75% of viable tumor cells.


Locations(1)

Blokhin's Russian Cancer Research Center

Moscow, Russia

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NCT07464470


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