Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
School of Medicine, Tongji University, Shanghai, China.
Front Immunol. 2023 Oct 24;14:1297588. doi: 10.3389/fimmu.2023.1297588. eCollection 2023.
BACKGROUND: Despite the acknowledged predictive value of KRAS in immune checkpoint inhibitor (ICI) responses, the heterogeneous behavior of its mutations in this sphere remains largely unexplored. As of now, no studies have definitively categorized KRAS subtype variations as independent prognostic indicators for ICI responses in lung cancer patients. METHODS: We analyzed a cohort of 103 patients, all harboring different KRAS mutation subtypes, and complemented this data with information from TCGA and GEO databases. Our research focused on delineating the relationships between KRAS mutation subtypes and factors like immunotherapy markers and immune cell composition, in addition to examining survival rates, drug sensitivity, and PD-L1 responses corresponding to distinct KRAS subtypes. RESULTS: We found that the G12V and G12D subtypes demonstrated elevated expressions of immunotherapy markers, implying a potentially enhanced benefit from immunotherapy. Significant variations were identified in the distribution of naive B cells, activated CD4+ memory T cells, and regulatory T cells (Tregs) across different KRAS mutant subtypes. A notable difference was observed in the Tumor Mutation Burden (TMB) levels across the four KRAS subtypes, with the G12D subtype displaying the lowest TMB level. Furthermore, G12C subtype showcased the worst prognosis in terms of progression-free intervals (PFI), in stark contrast to the more favorable outcomes associated with the G12A subtype. CONCLUSION: Our study reveals that KRAS mutations exhibit considerable variability in predicting outcomes for LUAD patients undergoing ICI treatment. Thus, the evaluation of KRAS as a biomarker for ICIs necessitates recognizing the potential diversity inherent in KRAS mutations.
背景:尽管 KRAS 突变被公认具有预测免疫检查点抑制剂(ICI)反应的价值,但在这一领域,其突变的异质性行为在很大程度上仍未得到探索。到目前为止,还没有研究明确将 KRAS 亚型变化归类为肺癌患者接受 ICI 治疗的独立预后指标。
方法:我们分析了 103 名患者的队列,这些患者都携带不同的 KRAS 突变亚型,并结合 TCGA 和 GEO 数据库中的信息进行了补充。我们的研究重点是描绘 KRAS 突变亚型与免疫治疗标志物和免疫细胞组成等因素之间的关系,此外还研究了不同 KRAS 亚型对应的生存率、药物敏感性和 PD-L1 反应。
结果:我们发现 G12V 和 G12D 亚型的免疫治疗标志物表达水平升高,表明它们可能从免疫治疗中获益更大。在不同 KRAS 突变亚型中,幼稚 B 细胞、激活的 CD4+记忆 T 细胞和调节性 T 细胞(Tregs)的分布存在显著差异。在四个 KRAS 亚型中,TMB 水平存在明显差异,G12D 亚型的 TMB 水平最低。此外,G12C 亚型的无进展间隔(PFI)最差,与 G12A 亚型相关的预后较好形成鲜明对比。
结论:我们的研究表明,KRAS 突变在预测接受 ICI 治疗的 LUAD 患者的结局方面存在显著的可变性。因此,将 KRAS 作为 ICI 生物标志物的评估需要认识到 KRAS 突变所固有的潜在多样性。
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