Department of Breast Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, China.
Cancer Med. 2023 Mar;12(5):5195-5208. doi: 10.1002/cam4.5314. Epub 2022 Nov 20.
There were limitations existing in programmed cell-death ligand 1 (PD-L1) as predictive biomarkers for breast cancer (BC), hence exploring the correlation between PD-L1 levels and other biomarkers in BC may become a very useful therapeutic clinical tool.
A total of 301 Chinese patients with different BC subtypes including 47 HR+/HER2+, 185 HR+/HER2-, 38 HR-/HER2+, and 31 triple-negative breast cancer (TNBC) were enrolled in our study. Next-generation sequencing based Yuansu450 gene panel was used for genomic alteration identification and PD-L1 expression was tested using immunohistochemistry.
The most prevalent BC-related mutations were TP53 mutations, followed by mutations in PIK3CA, ERBB2, CDK12, and GATA3 in our Chinese cohort. We found that mutations DDR2 and MYCL were only mutated in HR-/HER2+ subtype, whereas H3-3A and NRAS mutations were only occurred in HR-/HER2- subtype. The percentage of patients with PD-L1-positive expression was higher in patients with HR-/HER2- mainly due to the percentage of PD-L1-high level. Mutational frequencies of TP53, MYC, FAT4, PBRM1, PREX2 were observed to have significant differences among patients with different BC subtypes based on PD-L1 levels. Moreover, a positive correlation was observed between TMB and PD-L1 level in HR+/HER2- subtype, and showed that the proportion of patients with high PD-L1 expression was higher than that of patients with low PD-L1 expression in the HR+/HER2- and HR+/HER2+ cohorts with high Ki67 expression.
The genomic alterations based on PD-L1 and other biomarkers of different cohorts may provide more possibilities for the treatment of BC with different subtypes.
程序性细胞死亡配体 1(PD-L1)作为预测乳腺癌(BC)的生物标志物存在局限性,因此探索 PD-L1 水平与 BC 中其他生物标志物的相关性可能成为一种非常有用的治疗临床工具。
本研究共纳入 301 例不同 BC 亚型的中国患者,包括 47 例 HR+/HER2+、185 例 HR+/HER2-、38 例 HR-/HER2+和 31 例三阴性乳腺癌(TNBC)。采用基于下一代测序的元溯 450 基因 panel 进行基因组改变鉴定,采用免疫组织化学法检测 PD-L1 表达。
在我们的中国队列中,最常见的 BC 相关突变是 TP53 突变,其次是 PIK3CA、ERBB2、CDK12 和 GATA3 突变。我们发现,DDR2 和 MYCL 突变仅在 HR-/HER2+亚型中发生突变,而 H3-3A 和 NRAS 突变仅在 HR-/HER2-亚型中发生。由于 PD-L1 高水平的比例较高,HR-/HER2-型患者中 PD-L1 阳性表达的患者比例较高。基于 PD-L1 水平,不同 BC 亚型患者的 TP53、MYC、FAT4、PBRM1、PREX2 突变频率观察到显著差异。此外,在 HR+/HER2-亚型中观察到 TMB 与 PD-L1 水平之间存在正相关,并且在 HR+/HER2-和 HR+/HER2+队列中,Ki67 表达高的患者中高 PD-L1 表达的患者比例高于低 PD-L1 表达的患者比例。
不同队列中基于 PD-L1 和其他生物标志物的基因组改变可能为不同亚型的 BC 治疗提供更多可能性。