Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 East Dongfeng Road, Guangzhou, 510060, China.
School of Biomedical Sciences, Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Hong Kong, 999077, China.
Adv Sci (Weinh). 2023 Feb;10(5):e2203699. doi: 10.1002/advs.202203699. Epub 2022 Dec 18.
Distant metastasis remains the major cause of morbidity for breast cancer. Individuals with liver or brain metastasis have an extremely poor prognosis and low response rates to anti-PD-1/L1 immune checkpoint therapy compared to those with metastasis at other sites. Therefore, it is urgent to investigate the underlying mechanism of anti-PD-1/L1 resistance and develop more effective immunotherapy strategies for these patients. Using single-cell RNA sequencing, a high-resolution map of the entire tumor ecosystem based on 44 473 cells from breast cancer liver and brain metastases is depicted. Identified by canonical markers and confirmed by multiplex immunofluorescent staining, the metastatic ecosystem features remarkable reprogramming of immunosuppressive cells such as FOXP3+ regulatory T cells, LAMP3+ tolerogenic dendritic cells, CCL18+ M2-like macrophages, RGS5+ cancer-associated fibroblasts, and LGALS1+ microglial cells. In addition, PD-1 and PD-L1/2 are barely expressed in CD8+ T cells and cancer/immune/stromal cells, respectively. Interactions of the immune checkpoint molecules LAG3-LGALS3 and TIGIT-NECTIN2 between CD8+ T cells and cancer/immune/stromal cells are found to play dominant roles in the immune escape. In summary, this study dissects the intratumoral heterogeneity and immunosuppressive microenvironment in liver and brain metastases of breast cancer for the first time, providing insights into the most appropriate immunotherapy strategies for these patients.
远处转移仍然是乳腺癌发病的主要原因。与其他部位转移的患者相比,肝转移或脑转移患者的预后极差,对 PD-1/L1 免疫检查点治疗的反应率低。因此,迫切需要研究抗 PD-1/L1 耐药的潜在机制,并为这些患者开发更有效的免疫治疗策略。本研究通过单细胞 RNA 测序,对来自乳腺癌肝转移和脑转移的 44473 个细胞进行了全肿瘤生态系统的高分辨率图谱描绘。通过典型标志物鉴定,并通过多重免疫荧光染色进行验证,转移性生态系统的特征是免疫抑制细胞的显著重编程,如 FOXP3+调节性 T 细胞、LAMP3+耐受性树突状细胞、CCL18+M2 样巨噬细胞、RGS5+癌相关成纤维细胞和 LGALS1+小胶质细胞。此外,CD8+T 细胞和癌症/免疫/基质细胞中分别很少表达 PD-1 和 PD-L1/2。发现 CD8+T 细胞与癌症/免疫/基质细胞之间的免疫检查点分子 LAG3-LGALS3 和 TIGIT-NECTIN2 的相互作用在免疫逃逸中起主导作用。总之,本研究首次剖析了乳腺癌肝转移和脑转移的肿瘤内异质性和免疫抑制微环境,为这些患者提供了最合适的免疫治疗策略的见解。
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