肾癌的分子亚型决定了对检查点和血管生成抑制的疗效。
Molecular Subsets in Renal Cancer Determine Outcome to Checkpoint and Angiogenesis Blockade.
机构信息
Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Oncology Biomarker Development, Genentech, Inc, South San Francisco, CA 94080, USA.
出版信息
Cancer Cell. 2020 Dec 14;38(6):803-817.e4. doi: 10.1016/j.ccell.2020.10.011. Epub 2020 Nov 5.
Integrated multi-omics evaluation of 823 tumors from advanced renal cell carcinoma (RCC) patients identifies molecular subsets associated with differential clinical outcomes to angiogenesis blockade alone or with a checkpoint inhibitor. Unsupervised transcriptomic analysis reveals seven molecular subsets with distinct angiogenesis, immune, cell-cycle, metabolism, and stromal programs. While sunitinib and atezolizumab + bevacizumab are effective in subsets with high angiogenesis, atezolizumab + bevacizumab improves clinical benefit in tumors with high T-effector and/or cell-cycle transcription. Somatic mutations in PBRM1 and KDM5C associate with high angiogenesis and AMPK/fatty acid oxidation gene expression, while CDKN2A/B and TP53 alterations associate with increased cell-cycle and anabolic metabolism. Sarcomatoid tumors exhibit lower prevalence of PBRM1 mutations and angiogenesis markers, frequent CDKN2A/B alterations, and increased PD-L1 expression. These findings can be applied to molecularly stratify patients, explain improved outcomes of sarcomatoid tumors to checkpoint blockade versus antiangiogenics alone, and develop personalized therapies in RCC and other indications.
对 823 例晚期肾细胞癌 (RCC) 患者的多组学综合评估确定了与血管生成阻断单药或与检查点抑制剂联合治疗的不同临床结局相关的分子亚群。非监督转录组分析揭示了具有不同血管生成、免疫、细胞周期、代谢和基质程序的七个分子亚群。虽然舒尼替尼和阿替利珠单抗联合贝伐珠单抗在高血管生成亚群中有效,但阿替利珠单抗联合贝伐珠单抗可提高高 T 效应细胞和/或细胞周期转录肿瘤的临床获益。PBRM1 和 KDM5C 的体细胞突变与高血管生成和 AMPK/脂肪酸氧化基因表达相关,而 CDKN2A/B 和 TP53 改变与细胞周期和合成代谢增加相关。肉瘤样肿瘤表现出较低的 PBRM1 突变和血管生成标志物的发生率,频繁的 CDKN2A/B 改变,以及增加的 PD-L1 表达。这些发现可用于对患者进行分子分层,解释肉瘤样肿瘤对检查点阻断与抗血管生成治疗相比的改善结局,并在 RCC 和其他适应症中开发个性化治疗方法。
相似文献
Cancer Cell. 2020-12-14
Nat Commun. 2021-6-25
Clin Genitourin Cancer. 2019-5-25
引用本文的文献
本文引用的文献
Nat Rev Cancer. 2019-10-30
Cancers (Basel). 2019-4-30
N Engl J Med. 2019-2-16
N Engl J Med. 2019-2-16