Division of Surgical Oncology, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Sylvester Comprehensive Cancer Center, Miami, FL, USA.
Oncogene. 2022 Jul;41(28):3640-3654. doi: 10.1038/s41388-022-02368-w. Epub 2022 Jun 14.
Co-occurrent KRAS and TP53 mutations define a majority of patients with pancreatic ductal adenocarcinoma (PDAC) and define its pro-metastatic proclivity. Here, we demonstrate that KRAS-TP53 co-alteration is associated with worse survival compared with either KRAS-alone or TP53-alone altered PDAC in 245 patients with metastatic disease treated at a tertiary referral cancer center, and validate this observation in two independent molecularly annotated datasets. Compared with non-TP53 mutated KRAS-altered tumors, KRAS-TP53 co-alteration engenders disproportionately innate immune-enriched and CD8 T-cell-excluded immune signatures. Leveraging in silico, in vitro, and in vivo models of human and murine PDAC, we discover a novel intersection between KRAS-TP53 co-altered transcriptomes, TP63-defined squamous trans-differentiation, and myeloid-cell migration into the tumor microenvironment. Comparison of single-cell transcriptomes between KRAS-TP53 co-altered and KRAS-altered/TP53 tumors revealed cancer cell-autonomous transcriptional programs that orchestrate innate immune trafficking and function. Moreover, we uncover granulocyte-derived inflammasome activation and TNF signaling as putative paracrine mediators of innate immunoregulatory transcriptional programs in KRAS-TP53 co-altered PDAC. Immune subtyping of KRAS-TP53 co-altered PDAC reveals conflation of intratumor heterogeneity with progenitor-like stemness properties. Coalescing these distinct molecular characteristics into a KRAS-TP53 co-altered "immunoregulatory program" predicts chemoresistance in metastatic PDAC patients enrolled in the COMPASS trial, as well as worse overall survival.
KRAS 和 TP53 同时发生突变定义了大多数胰腺导管腺癌(PDAC)患者,并定义了其促转移的倾向。在这里,我们证明与 KRAS 单独或 TP53 单独改变的 PDAC 相比,转移性疾病在三级转诊癌症中心治疗的 245 名患者中,KRAS-TP53 共改变与较差的生存相关,并且在两个独立的分子注释数据集验证了这一观察结果。与非 TP53 突变的 KRAS 改变的肿瘤相比,KRAS-TP53 共改变导致不成比例的固有免疫丰富和 CD8 T 细胞排斥的免疫特征。利用人类和鼠 PDAC 的计算机模拟、体外和体内模型,我们发现了 KRAS-TP53 共改变的转录组、TP63 定义的鳞状转化和髓样细胞向肿瘤微环境迁移之间的一个新的交叉点。KRAS-TP53 共改变和 KRAS 改变/TP53 肿瘤之间的单细胞转录组比较揭示了协调固有免疫运输和功能的肿瘤细胞自主转录程序。此外,我们发现粒细胞衍生的炎性小体激活和 TNF 信号作为 KRAS-TP53 共改变 PDAC 中固有免疫调节转录程序的潜在旁分泌介质。KRAS-TP53 共改变 PDAC 的免疫亚群揭示了肿瘤内异质性与祖细胞样干性特性的融合。将这些不同的分子特征合并为 KRAS-TP53 共改变的“免疫调节程序”,预测了 COMPASS 试验中转移性 PDAC 患者的化疗耐药性以及总体生存率更差。