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通过靶向测序进行基因组评分,以确定免疫治疗的临床获益。

Genomic scoring to determine clinical benefit of immunotherapy by targeted sequencing.

机构信息

Division of Hematology-Oncology, Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Department of Health Sciences and Technology, Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University, Seoul, South Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Eur J Cancer. 2019 Oct;120:65-74. doi: 10.1016/j.ejca.2019.08.001. Epub 2019 Sep 4.


DOI:10.1016/j.ejca.2019.08.001
PMID:31493723
Abstract

AIMS: Immune checkpoint inhibitors (ICIs) induce durable responses, but their clinical benefits apply to only a subset of patients. Therefore, precisely predicting a patient's response before ICI treatment is crucial. METHODS: A total of 248 patients with anti-Programmed cell death protein 1/Programmed death-ligand 1 (PD1/PD-L1)-treated advanced non-small cell lung cancer were enrolled, and clinical outcomes were collected with a minimum 6-month follow-up period. Tumour tissues were used for PD-L1 staining, targeted sequencing of 380 cancer-related genes and whole-exome sequencing (WES). RESULTS: The tumour mutation burden (TMB) obtained from targeted sequencing was higher among patients with a partial response (PR) than those with progressive disease (PD)/stable disease (SD) (P = 0.01) and in those with durable clinical benefit (DCB) than nondurable benefit (NDB) (P = 0.05). The somatic copy number alteration (SCNA) was lower in patients with a PR than those with PD/SD (P = 0.02) and in those with DCB than NDB (P = 0.02). The accuracy of the TMB and SCNA results from the targeted sequencing was confirmed by testing the correlation of the TMB and SCNA results from the targeted sequencing against those results from WES (r = 0.87, r = 0.62, respectively). To improve prediction score, TMB, SCNA and PD-L1 were integrated. New prediction scores reached Area under the ROC Curve (AUC) = 0.71 from TMB (AUC = 0.63), SCNA (AUC = 0.52) or PD-L1 (AUC = 0.57) with our cohort, and validation set from other cohorts also showed improved prediction scores with our new model. CONCLUSION: We report TMB, SCNA and PD-L1 as ICI biomarkers. Combining all these factors improved the prediction accuracy of ICI response compared with using individual factors. Tumour molecular features, TMB and SCNA, were efficiently obtained by targeted sequencing.

摘要

目的:免疫检查点抑制剂(ICI)可诱导持久反应,但它们的临床获益仅适用于一部分患者。因此,在ICI 治疗前准确预测患者的反应至关重要。

方法:共纳入 248 例接受抗程序性死亡蛋白 1/程序性死亡配体 1(PD1/PD-L1)治疗的晚期非小细胞肺癌患者,采集患者的临床结局数据,并进行至少 6 个月的随访。采用 PD-L1 染色、380 个癌症相关基因靶向测序和全外显子组测序(WES)检测肿瘤组织。

结果:靶向测序获得的肿瘤突变负荷(TMB)在部分缓解(PR)患者中高于进展性疾病(PD)/疾病稳定(SD)患者(P=0.01)和具有持久临床获益(DCB)患者高于无持久临床获益(NDB)患者(P=0.05)。PR 患者的体细胞拷贝数改变(SCNA)低于 PD/SD 患者(P=0.02)和 NDB 患者(P=0.02)。靶向测序的 TMB 和 SCNA 结果的准确性通过测试靶向测序的 TMB 和 SCNA 结果与 WES 结果的相关性得到证实(r=0.87,r=0.62)。为了提高预测评分,整合了 TMB、SCNA 和 PD-L1。新的预测评分在我们的队列中,TMB(AUC=0.63)、SCNA(AUC=0.52)或 PD-L1(AUC=0.57)的 AUC 值分别为 0.71,从其他队列的验证集中,我们的新模型也显示出了改进的预测评分。

结论:我们报告 TMB、SCNA 和 PD-L1 作为 ICI 生物标志物。与使用单一因素相比,结合所有这些因素可提高 ICI 反应的预测准确性。通过靶向测序可以有效地获得肿瘤分子特征、TMB 和 SCNA。

相似文献

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Genomic scoring to determine clinical benefit of immunotherapy by targeted sequencing.

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[2]
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J Clin Oncol. 2018-1-16

[3]
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J Pathol. 2019-10-24

[4]
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[5]
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[6]
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[8]
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[10]
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Tumor aneuploidy as a prognostic and predictive biomarker in immune checkpoint blockade.

Nat Genet. 2025-6-30

[2]
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Nat Commun. 2024-10-20

[3]
Comparative analysis of PD-L1 expression and molecular alterations in primary versus metastatic lung adenocarcinoma: a real-world study in China.

Front Oncol. 2024-9-11

[4]
Single-cell RNA sequencing analysis reveals the distinct features of colorectal cancer with or without infection in PD-L1 blockade therapy.

Heliyon. 2024-9-6

[5]
Therapeutic guidance of tumor mutation burden on immune checkpoint inhibitors in advanced non-small cell lung cancer: a systematic review and comprehensive meta-analysis.

J Natl Cancer Cent. 2021-12-1

[6]
Association between immune-related adverse events and prognosis in patients with advanced non-small cell lung cancer: a systematic review and meta-analysis.

Front Oncol. 2024-5-8

[7]
Tumor Copy Number Alteration Burden as a Predictor for Resistance to Immune Checkpoint Blockade across Different Cancer Types.

Cancers (Basel). 2024-2-9

[8]
Chemokine- and chemokine receptor-based signature predicts immunotherapy response in female colorectal adenocarcinoma patients.

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[9]
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[10]
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