Patients with high tumor mutational burden(TMB)levels do not consistently respond to immune checkpoint inhibitors(ICIs),possibly because a high TMB level does not necessarily result in adequate infiltration of CD8^(+)...Patients with high tumor mutational burden(TMB)levels do not consistently respond to immune checkpoint inhibitors(ICIs),possibly because a high TMB level does not necessarily result in adequate infiltration of CD8^(+)T cells.Using bulk ribonucleic acid sequencing(RNA-seq)data from 9311 tumor samples across 30 cancer types,we developed a novel tool called the modulator of TMB-associated immune infiltration(MOTIF),which comprises genes that can determine the extent of CD8^(+)T cell infiltration prompted by a certain TMB level.We confirmed that MOTIF can accurately reflect the integrity and defects of the cancer-immunity cycle.By analyzing 84 human single-cell RNA-seq datasets from 32 types of solid tumors,we revealed that MOTIF can provide insights into the diverse roles of various cell types in the modulation of CD8^(+)T cell infiltration.Using pretreatment RNA-seq data from 13 ICI-treated cohorts,we validated the use of MOTIF in predicting CD8^(+)T cell infiltration and ICI efficacy.Among the components of MOTIF,we identified EMC3 as a negative regulator of CD8^(+)T cell infiltration,which was validated via in vivo studies.Additionally,MOTIF provided guidance for the potential combinations of programmed death 1 blockade with certain immunostimulatory drugs to facilitate CD8^(+)T cell infiltration and improve ICI efficacy.展开更多
Background Circulating tumor DNA(ctDNA)is a promising biomarker for predicting relapse in multiple solid cancers.However,the predictive value of ctDNA for disease recurrence remains indefinite in locoregional gastric ...Background Circulating tumor DNA(ctDNA)is a promising biomarker for predicting relapse in multiple solid cancers.However,the predictive value of ctDNA for disease recurrence remains indefinite in locoregional gastric cancer(GC).Here,we aimed to evaluate the predictive value of ctDNA in this context.Methods From 2016 to 2019,100 patients with stage II/III resectable GC were recruited in this prospective cohort study(NCT02887612).Primary tumors were collected during surgical resection,and plasma samples were collected perioperatively and within 3 months after adjuvant chemotherapy(ACT).Somatic variants were captured via a targeted sequencing panel of 425 cancer-related genes.The plasma was defined as ctDNA-positive only if one or more variants detected in the plasma were presented in at least 2%of the primary tumors.Results Compared with ctDNA-negative patients,patients with positive postoperative ctDNA had moderately higher risk of recurrence[hazard ratio(HR)=2.74,95%confidence interval(CI)=1.37–5.48;P=0.003],while patients with positive post-ACT ctDNA showed remarkably higher risk(HR=14.99,95%CI=3.08-72.96;P<0.001).Multivariate analyses indicated that both postoperative and post-ACT ctDNA positivity were independent predictors of recurrence-free survival(RFS).Moreover,post-ACT ctDNA achieved better predictive performance(sensitivity,77.8%;specificity,90.6%)than both postoperative ctDNA and serial cancer antigen.A comprehensive model incorporating ctDNA for recurrence risk prediction showed a higher C-index(0.78;95%CI=0.71–0.84)than the model without ctDNA(0.71;95%CI=0.64–0.79;P=0.009).Conclusions Residual ctDNA after ACT effectively predicts high recurrence risk in stage II/III GC,and the combination of tissue-based and circulating tumor features could achieve better risk prediction.展开更多
The acidic tumor microenvironment provides an energy source driving malignant tumor progression.Adaptation of cells to an acidic environment leads to the emergence of cancer stem cells.The expression of the vitamin D ...The acidic tumor microenvironment provides an energy source driving malignant tumor progression.Adaptation of cells to an acidic environment leads to the emergence of cancer stem cells.The expression of the vitamin D receptor(VDR)is closely related to the initiation and development of colorectal carcinoma(CRC),but its regulatory mechanism in CRC stem cells is still unclear.Our study revealed that acidosis reduced VDR expression by downregulating peroxisome proliferator-activated receptor delta(PPARD)expression.Overexpression of VDR effectively suppressed the stemness and oxaliplatin resistance of cells in acidosis.The nuclear export signal in VDR was sensitive to acidosis,and VDR was exported from the nucleus.Chromatin immunoprecipitation(ChIP)and assay for transposase-accessible chromatin with high-throughput sequencing(ATAC-seq)analyses showed that VDR transcriptionally repressed SRY-box 2(SOX2)by binding to the vitamin D response elements in the promoter of SOX2,impairing tumor growth and drug resistance.We demonstrated that a change in the acidic microenvironment combined with overexpression of VDR substantially restricted the occurrence and development of CRC in vivo.These findings reveal a new mechanism by which acidosis could affect the stemness of CRC cells by regulating the expression of SOX2 and show that abnormal VDR expression leads to ineffective activation of vitamin D signaling,resulting in a lack of efficacy of vitamin D in antineoplastic process.展开更多
Background Due to its limited efficacy and potential toxicity,anti-PD-1 monoclonal antibody is not suitable for all advanced gastric cancer(AGC)patients and predictive biomarkers identifying patients who can benefit f...Background Due to its limited efficacy and potential toxicity,anti-PD-1 monoclonal antibody is not suitable for all advanced gastric cancer(AGC)patients and predictive biomarkers identifying patients who can benefit from it are urgently needed.This study aimed to evaluate the predictive and prognostic value of inflammatory markers in the context of the systemic inflammatory status and tumour microenvironment.Methods The study included 58 patients from a prospective study investigating the safety and efficacy of toripalimab in chemorefractory AGC patients.Patient characteristics,treatment outcomes,and haematological parameters were analysed.Immune-cell infiltration and gene expression in tumour tissue were examined using transcriptome sequencing.Results In this cohort,the median follow-up time was 4.5 months,the median progression-free survival was 1.9 months,and the median overall survival(OS)was 4.8 months.The objective response rate was 12.1%and th disease control rate(DCR)was 39.7%.Both the baseline blood neutrophil-to-lymphocyte ratio(bNLR)with a cut-point of 2.7 and the early elevated dynamic change of the bNLR(dNLR)with a cut-point of 1.5 were prognostic factors of survival.Patients in the high bNLR or dNLR group had remarkably poor DCR(25.8%vs 59.1%,P=0.023;15.8%vs 54.6%,P=0.008).In multivariate analysis,bNLR and tumour mutational burden were independent prognostic factors of OS.Tumour RNA-seq analysis revealed enriched neutrophil infiltration and a higher tumour NLR in the bNLR-high group.Corresponding tumour gene-expression profiles were associated with neutrophil recruitment and inflammatory cytokine aggregation.Conclusions Our study demonstrated the potential clinical utility of NLR as a biomarker for patient selection and clinical management in predicting the prognosis of AGC patients as well as response to anti-PD-1 therapy.In addition,high bNLR reflected the imbalance of tumour-tissue-infiltrating neutrophils and lymphocytes,and was associated with an immunosuppressive and pro-tumour microenvironment.展开更多
基金supported by the National Natural Science Foundation of China(81930065,82173128,82102921,and 82003269)the Cancer Innovation Research Program of Sun Yat-sen University Cancer Center(CIRP-SYSUCC-0004)+5 种基金the Swedish Research Council(VR-MH 2014-46602-117891-30)the CAMS Innovation Fund for Medical Sciences(CIFMS)(2019-I2M-5-036)the Youth Teacher Cultivation Program of Sun Yat-sen UniversityGuangdong Provincial Clinical Medical Research Center for Malignant Tumors(84000-31660002)the China Postdoctoral Science Foundation(2023M744049)the Chih Kuang Scholarship for Outstanding Young Physician-Scientists of Sun Yat-sen University Cancer Center(CKS-SYSUCC-2023001)。
文摘Patients with high tumor mutational burden(TMB)levels do not consistently respond to immune checkpoint inhibitors(ICIs),possibly because a high TMB level does not necessarily result in adequate infiltration of CD8^(+)T cells.Using bulk ribonucleic acid sequencing(RNA-seq)data from 9311 tumor samples across 30 cancer types,we developed a novel tool called the modulator of TMB-associated immune infiltration(MOTIF),which comprises genes that can determine the extent of CD8^(+)T cell infiltration prompted by a certain TMB level.We confirmed that MOTIF can accurately reflect the integrity and defects of the cancer-immunity cycle.By analyzing 84 human single-cell RNA-seq datasets from 32 types of solid tumors,we revealed that MOTIF can provide insights into the diverse roles of various cell types in the modulation of CD8^(+)T cell infiltration.Using pretreatment RNA-seq data from 13 ICI-treated cohorts,we validated the use of MOTIF in predicting CD8^(+)T cell infiltration and ICI efficacy.Among the components of MOTIF,we identified EMC3 as a negative regulator of CD8^(+)T cell infiltration,which was validated via in vivo studies.Additionally,MOTIF provided guidance for the potential combinations of programmed death 1 blockade with certain immunostimulatory drugs to facilitate CD8^(+)T cell infiltration and improve ICI efficacy.
基金support by the Science and Technology Program of Guangdong(2019B020227002,to RHX)the CAMS Innovation Fund for Medical Sciences(CIFMS)(2019-I2M-5-036,to RHX)+4 种基金the International Cooperation and Exchanges National Natural Science Foundation of China(82061160373,to FW)the National Natural Science Foundation of China(General Program,81872011,to FW)the Sun Yat-sen University Clinical Research 5010 Program(2018014,to FW)the Young Physician Scientist Program of Sun Yat-sen University Cancer Center(16zxqk03,to FW)the Guangdong Esophageal Cancer Institute Science and Technology Program(M202210,to SQY).
文摘Background Circulating tumor DNA(ctDNA)is a promising biomarker for predicting relapse in multiple solid cancers.However,the predictive value of ctDNA for disease recurrence remains indefinite in locoregional gastric cancer(GC).Here,we aimed to evaluate the predictive value of ctDNA in this context.Methods From 2016 to 2019,100 patients with stage II/III resectable GC were recruited in this prospective cohort study(NCT02887612).Primary tumors were collected during surgical resection,and plasma samples were collected perioperatively and within 3 months after adjuvant chemotherapy(ACT).Somatic variants were captured via a targeted sequencing panel of 425 cancer-related genes.The plasma was defined as ctDNA-positive only if one or more variants detected in the plasma were presented in at least 2%of the primary tumors.Results Compared with ctDNA-negative patients,patients with positive postoperative ctDNA had moderately higher risk of recurrence[hazard ratio(HR)=2.74,95%confidence interval(CI)=1.37–5.48;P=0.003],while patients with positive post-ACT ctDNA showed remarkably higher risk(HR=14.99,95%CI=3.08-72.96;P<0.001).Multivariate analyses indicated that both postoperative and post-ACT ctDNA positivity were independent predictors of recurrence-free survival(RFS).Moreover,post-ACT ctDNA achieved better predictive performance(sensitivity,77.8%;specificity,90.6%)than both postoperative ctDNA and serial cancer antigen.A comprehensive model incorporating ctDNA for recurrence risk prediction showed a higher C-index(0.78;95%CI=0.71–0.84)than the model without ctDNA(0.71;95%CI=0.64–0.79;P=0.009).Conclusions Residual ctDNA after ACT effectively predicts high recurrence risk in stage II/III GC,and the combination of tissue-based and circulating tumor features could achieve better risk prediction.
基金supported by grants from the National Natural Science Foundation of China(81930065,81802971)Science and Technology Program of Guangdong(2019B020227002)+3 种基金Science and Technology Program of Guangzhou(201904020046,201803040019,201704020228)CAMS Innovation Fund for Medical Sciences(2019-I2M-5-036)China Postdoctoral Science Foundation(2018M643301),China Postdoctoral Innovative Talent Support ProgramNatural Science Foundation of Guangdong(2018A0303130282,2019A1515011109).
文摘The acidic tumor microenvironment provides an energy source driving malignant tumor progression.Adaptation of cells to an acidic environment leads to the emergence of cancer stem cells.The expression of the vitamin D receptor(VDR)is closely related to the initiation and development of colorectal carcinoma(CRC),but its regulatory mechanism in CRC stem cells is still unclear.Our study revealed that acidosis reduced VDR expression by downregulating peroxisome proliferator-activated receptor delta(PPARD)expression.Overexpression of VDR effectively suppressed the stemness and oxaliplatin resistance of cells in acidosis.The nuclear export signal in VDR was sensitive to acidosis,and VDR was exported from the nucleus.Chromatin immunoprecipitation(ChIP)and assay for transposase-accessible chromatin with high-throughput sequencing(ATAC-seq)analyses showed that VDR transcriptionally repressed SRY-box 2(SOX2)by binding to the vitamin D response elements in the promoter of SOX2,impairing tumor growth and drug resistance.We demonstrated that a change in the acidic microenvironment combined with overexpression of VDR substantially restricted the occurrence and development of CRC in vivo.These findings reveal a new mechanism by which acidosis could affect the stemness of CRC cells by regulating the expression of SOX2 and show that abnormal VDR expression leads to ineffective activation of vitamin D signaling,resulting in a lack of efficacy of vitamin D in antineoplastic process.
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS)[2019-I2M-5-036]the Science and Technology Program of Guangdong[2019B020227002].
文摘Background Due to its limited efficacy and potential toxicity,anti-PD-1 monoclonal antibody is not suitable for all advanced gastric cancer(AGC)patients and predictive biomarkers identifying patients who can benefit from it are urgently needed.This study aimed to evaluate the predictive and prognostic value of inflammatory markers in the context of the systemic inflammatory status and tumour microenvironment.Methods The study included 58 patients from a prospective study investigating the safety and efficacy of toripalimab in chemorefractory AGC patients.Patient characteristics,treatment outcomes,and haematological parameters were analysed.Immune-cell infiltration and gene expression in tumour tissue were examined using transcriptome sequencing.Results In this cohort,the median follow-up time was 4.5 months,the median progression-free survival was 1.9 months,and the median overall survival(OS)was 4.8 months.The objective response rate was 12.1%and th disease control rate(DCR)was 39.7%.Both the baseline blood neutrophil-to-lymphocyte ratio(bNLR)with a cut-point of 2.7 and the early elevated dynamic change of the bNLR(dNLR)with a cut-point of 1.5 were prognostic factors of survival.Patients in the high bNLR or dNLR group had remarkably poor DCR(25.8%vs 59.1%,P=0.023;15.8%vs 54.6%,P=0.008).In multivariate analysis,bNLR and tumour mutational burden were independent prognostic factors of OS.Tumour RNA-seq analysis revealed enriched neutrophil infiltration and a higher tumour NLR in the bNLR-high group.Corresponding tumour gene-expression profiles were associated with neutrophil recruitment and inflammatory cytokine aggregation.Conclusions Our study demonstrated the potential clinical utility of NLR as a biomarker for patient selection and clinical management in predicting the prognosis of AGC patients as well as response to anti-PD-1 therapy.In addition,high bNLR reflected the imbalance of tumour-tissue-infiltrating neutrophils and lymphocytes,and was associated with an immunosuppressive and pro-tumour microenvironment.
