Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States.
J Immunother Cancer. 2020 Aug;8(2). doi: 10.1136/jitc-2019-000336.
Recent advances in T cell-related immunotherapy have brought remarkable progress in the treatment of non-small cell lung cancer (NSCLC). However, whether and how genetic variations of T cell cancer immune response genes can influence clinical outcomes of NSCLC patients remain obscure.
In this multiphase study, we assessed 2450 single-nucleotide polymorphisms (SNPs) from 280 T cell cancer immune response-related genes in 941 early-stage NSCLC patients (discovery n=536; validation n=405) to analyze the variants' associations with outcomes and to observe the effects on T cell phenotypes.
We found 14 SNPs in 10 genes were associated with NSCLC outcomes (p<0.05) in both phases. Among them, :rs1964986 was the most significant variant associated with recurrence risk after meta-analysis (HR 1.84, 95% CI 1.35 to 2.52, p=1.15E-04), while :rs10108662 was the most significant SNP associated with death risk (HR 1.87, 95% CI 1.40 to 2.51, p=2.17E-05). Analysis of unfavorable genotypes indicated cumulative effects on death and recurrence risks. Seven treatment-specific variants were found to predict opposite outcomes in surgery-only and surgery-plus-chemotherapy subgroups. Expression quantitative trait loci analysis indicated that six SNPs significantly correlated with their corresponding gene expression. T cells from high-risk subjects displayed reduced degranulation (p=0.02) and decreased cytotoxicity against cancer cells (p<0.01). Gene expression profile indicated increased IDO1 expression and decreased IL2, PRF and GZMB expression in high-risk subjects.
Genetic variations in T cell cancer immune response pathways can impact outcomes and may be served as predictors for treatment efficacy in early-stage NSCLC patients. The correlation between immune genotypes and T cell antitumor immunity suggests a biological link between host immune genetics and NSCLC prognosis.
T 细胞相关免疫疗法的最新进展为非小细胞肺癌(NSCLC)的治疗带来了显著的进展。然而,T 细胞癌症免疫反应基因的遗传变异是否以及如何影响 NSCLC 患者的临床结局仍不清楚。
在这项多阶段研究中,我们评估了 941 例早期 NSCLC 患者(发现阶段 n=536;验证阶段 n=405)中 280 个 T 细胞癌症免疫反应相关基因的 2450 个单核苷酸多态性(SNP),以分析变体与结局的关联,并观察对 T 细胞表型的影响。
我们发现,在两个阶段中,有 10 个基因的 14 个 SNP 与 NSCLC 结局相关(p<0.05)。其中,rs1964986 是经荟萃分析后与复发风险最显著相关的变体(HR 1.84,95%CI 1.35 至 2.52,p=1.15E-04),而 rs10108662 是与死亡风险最显著相关的 SNP(HR 1.87,95%CI 1.40 至 2.51,p=2.17E-05)。对不利基因型的分析表明,其对死亡和复发风险有累积效应。在仅手术和手术加化疗亚组中,发现 7 个治疗特异性变体可预测相反的结局。表达数量性状基因座分析表明,有 6 个 SNP 与相应的基因表达显著相关。高危组的 T 细胞脱颗粒减少(p=0.02),对癌细胞的细胞毒性降低(p<0.01)。基因表达谱表明,高危组 IDO1 表达增加,IL2、PRF 和 GZMB 表达减少。
T 细胞癌症免疫反应途径中的遗传变异可影响结局,并可作为早期 NSCLC 患者治疗效果的预测因子。免疫基因型与 T 细胞抗肿瘤免疫之间的相关性表明宿主免疫遗传学与 NSCLC 预后之间存在生物学联系。