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() 启动子低甲基化可预测转移性尿路上皮癌的免疫治疗反应。

() promoter hypomethylation predicts immunotherapy response in metastatic urothelial carcinoma.

机构信息

Department of Urology and Pediatric Urology, University Medical Center Bonn (UKB), Bonn, Germany.

Institute of Experimental Oncology, University Medical Center Bonn (UKB), Bonn, Germany.

出版信息

Oncoimmunology. 2023 Oct 19;12(1):2267744. doi: 10.1080/2162402X.2023.2267744. eCollection 2023.

Abstract

PD-L1 status assessed by immunohistochemistry (IHC) has failed to reliably predict outcomes for patients with metastatic urothelial carcinoma (mUC) on immune checkpoint blockade (ICB). promoter methylation is an epigenetic mechanism that has been shown to regulate mRNA expression in various malignancies. The aim of our present study was to evaluate the predictive potential of promoter methylation status () in ICB-treated mUC compared to conventional IHC-based PD-L1 assessment. We quantified in formalin-fixed and paraffin-embedded tissue sections using an established quantitative methylation-specific PCR assay (qMSP) in a well-characterized multicenter ICB-treated cohort comprising  = 107 patients with mUC. Additionally, PD-L1 protein expression in tumor tissues was assessed using regulatory approved IHC protocols. The effect of pharmacological hypomethylation by the DNA methyltransferase inhibitor decitabine in combination with interferon-γ stimulation in urothelial carcinoma cell lines was investigated by IHC and FACS. hypomethylation predicted objective response rate at the first staging on ICB. Patients with tumors categorized as hypomethylated (lower quartile) showed significantly prolonged progression-free (PFS) and overall survival (OS) after ICB initiation. In contrast, PD-L1 protein expression status neither correlated with response nor survival. In multivariable Cox regression analyses, promoter hypermethylation remained an independent predictor of unfavorable PFS and OS. In urothelial carcinoma cell lines, pharmacological demethylation led to an upregulation of membranous PD-L1 expression and an enhanced inducibility of PD-L1 expression by interferon γ. Hypomethylation of the promoter is a promising predictive biomarker for response to ICB in patients with mUC.

摘要

PD-L1 状态通过免疫组织化学(IHC)评估未能可靠预测接受免疫检查点阻断(ICB)治疗的转移性尿路上皮癌(mUC)患者的结局。启动子甲基化是一种表观遗传机制,已被证明可调节多种恶性肿瘤中的 mRNA 表达。我们目前的研究旨在评估与传统基于 IHC 的 PD-L1 评估相比,在接受 ICB 治疗的 mUC 中 启动子甲基化状态()的预测潜力。我们使用经过验证的定量甲基化特异性 PCR 检测(qMSP)在经过充分特征描述的、接受 ICB 治疗的多中心队列中,对 107 名 mUC 患者的福尔马林固定石蜡包埋组织切片进行了定量检测。此外,还使用监管批准的 IHC 方案评估了肿瘤组织中 PD-L1 蛋白的表达。通过 IHC 和 FACS 研究了 DNA 甲基转移酶抑制剂地西他滨联合干扰素-γ刺激对尿路上皮癌细胞系中 启动子去甲基化的药理作用。启动子低甲基化预测了 ICB 首次分期时的客观缓解率。在 ICB 启动后,将肿瘤归类为 启动子低甲基化(较低四分位数)的患者无进展生存期(PFS)和总生存期(OS)显著延长。相比之下,PD-L1 蛋白表达状态既与反应也与生存无关。在多变量 Cox 回归分析中,启动子高甲基化仍然是 PFS 和 OS 不良的独立预测因子。在尿路上皮癌细胞系中,药物去甲基化导致膜 PD-L1 表达上调,并增强了干扰素 γ 对 PD-L1 表达的诱导作用。 启动子低甲基化是 mUC 患者对 ICB 反应的有前途的预测生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79da/10588513/8f7a08395a51/KONI_A_2267744_F0001_OC.jpg

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