Yang Fan, Xiao Yi, Ding Jia-Han, Jin Xi, Ma Ding, Li Da-Qiang, Shi Jin-Xiu, Huang Wei, Wang Yi-Ping, Jiang Yi-Zhou, Shao Zhi-Ming
Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Cell Metab. 2023 Jan 3;35(1):84-100.e8. doi: 10.1016/j.cmet.2022.09.021. Epub 2022 Oct 17.
Treatment of triple-negative breast cancer (TNBC) remains challenging. Deciphering the orchestration of metabolic pathways in regulating ferroptosis will provide new insights into TNBC therapeutic strategies. Here, we integrated the multiomics data of our large TNBC cohort (n = 465) to develop the ferroptosis atlas. We discovered that TNBCs had heterogeneous phenotypes in ferroptosis-related metabolites and metabolic pathways. The luminal androgen receptor (LAR) subtype of TNBC was characterized by the upregulation of oxidized phosphatidylethanolamines and glutathione metabolism (especially GPX4), which allowed the utilization of GPX4 inhibitors to induce ferroptosis. Furthermore, we verified that GPX4 inhibition not only induced tumor ferroptosis but also enhanced antitumor immunity. The combination of GPX4 inhibitors and anti-PD1 possessed greater therapeutic efficacy than monotherapy. Clinically, higher GPX4 expression correlated with lower cytolytic scores and worse prognosis in immunotherapy cohorts. Collectively, this study demonstrated the ferroptosis landscape of TNBC and revealed an innovative immunotherapy combination strategy for refractory LAR tumors.
三阴性乳腺癌(TNBC)的治疗仍然具有挑战性。解读代谢途径在调节铁死亡中的调控机制将为TNBC治疗策略提供新的见解。在此,我们整合了我们大型TNBC队列(n = 465)的多组学数据,以构建铁死亡图谱。我们发现TNBC在铁死亡相关代谢物和代谢途径中具有异质性表型。TNBC的腔面雄激素受体(LAR)亚型的特征是氧化磷脂酰乙醇胺和谷胱甘肽代谢(尤其是GPX4)上调,这使得利用GPX4抑制剂诱导铁死亡成为可能。此外,我们证实抑制GPX4不仅能诱导肿瘤铁死亡,还能增强抗肿瘤免疫力。GPX4抑制剂与抗PD1联合使用比单一疗法具有更高的治疗效果。在临床上,较高的GPX4表达与免疫治疗队列中较低的细胞溶解评分和较差的预后相关。总体而言,本研究展示了TNBC的铁死亡格局,并揭示了一种针对难治性LAR肿瘤的创新免疫治疗联合策略。
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