Veas Rodriguez Joel, Piñol Miquel, Sorolla Maria Alba, Parisi Eva, Sorolla Anabel, Santacana Maria, Ruiz Maria, Parra Genís, Bernabeu Mario, Iglesias Mar, Aracil Carles, Escartin Alfredo, Vilardell Felip, Matias-Guiu Xavier, Salud Antonieta, Montal Robert
Department of Medical Oncology, Cancer Biomarkers Research Group, Hospital Universitari Arnau de Vilanova - IRBLleida, Lleida, Spain.
Department of Pathology, Oncological Pathology Group, Hospital Universitari Arnau de Vilanova - IRBLleida, Lleida, Spain.
J Immunother Cancer. 2025 Mar 18;13(3):e010024. doi: 10.1136/jitc-2024-010024.
BACKGROUND: Gastric adenocarcinoma (GAC) imposes a considerable global health burden. Molecular profiling of GAC from the tumor microenvironment perspective through a multi-omics approach is eagerly awaited in order to allow a more precise application of novel therapies in the near future. METHODS: To better understand the tumor-immune interface of GAC, we identified an internal cohort of 82 patients that allowed an integrative molecular analysis including mutational profiling by whole-exome sequencing, RNA gene expression of 770 genes associated with immune response, and multiplex protein expression at spatial resolution of 34 immuno-oncology targets at different compartments (tumorous cells and immune cells). Molecular findings were validated in 595 GAC from the TCGA and ACRG external cohorts with available multiomics data. Prediction of response to immunotherapies of the discovered immunophenotypes was assessed in 1039 patients with cancer from external cohorts with available transcriptome data. RESULTS: Unsupervised clustering by gene expression identified a subgroup of GAC that includes 52% of the tumors, the so-called Inflamed class, characterized by high tumor immunogenicity and cytotoxicity, particularly in the tumor center at protein level, with enrichment of and mutations and increased presence of exhausted CD8+ T cells as well as co-inhibitory receptors such as , , and . The remaining 48% of tumors were called non-inflamed based on the observed exclusion of T cell infiltration, with an overexpression of and higher presence of mutations, resulting in a worse clinical outcome. A 10-gene RNA signature was developed for the identification of tumors belonging to these classes, demonstrating in evaluated datasets comparable clinical utility in predicting response to current immunotherapies when tested against other published gene signatures. CONCLUSIONS: Comprehensive immunophenotyping of GAC identifies an inflamed class of tumors that complements previously proposed tumor-based molecular clusters. Such findings may provide the rationale for exploring novel immunotherapeutic approaches for biomarker-enriched populations in order to improve GAC patient's survival.
背景:胃腺癌(GAC)给全球带来了相当大的健康负担。人们迫切期待从肿瘤微环境角度通过多组学方法对GAC进行分子剖析,以便在不久的将来更精确地应用新疗法。 方法:为了更好地理解GAC的肿瘤免疫界面,我们确定了一个由82名患者组成的内部队列,该队列允许进行综合分子分析,包括通过全外显子测序进行突变分析、770个与免疫反应相关基因的RNA基因表达分析以及在不同区室(肿瘤细胞和免疫细胞)对34个免疫肿瘤学靶点进行空间分辨率的多重蛋白质表达分析。分子研究结果在来自TCGA和ACRG外部队列的595例GAC中得到验证,这些队列具有可用的多组学数据。在来自具有可用转录组数据的外部队列的1039例癌症患者中评估了所发现的免疫表型对免疫疗法反应的预测。 结果:通过基因表达进行的无监督聚类确定了一个GAC亚组,其中包括52%的肿瘤,即所谓的炎症类,其特征是高肿瘤免疫原性和细胞毒性,特别是在蛋白质水平的肿瘤中心,伴有 和 突变富集以及耗竭的CD8 + T细胞以及共抑制受体如 、 、 和 的存在增加。其余48%的肿瘤基于观察到的T细胞浸润排除被称为非炎症性肿瘤,伴有 过表达和 突变的更高发生率,导致更差的临床结果。开发了一种10基因RNA特征用于识别属于这些类别的肿瘤,在评估数据集中证明,当与其他已发表的基因特征进行测试时,在预测对当前免疫疗法的反应方面具有可比的临床效用。 结论:GAC的全面免疫表型分析确定了一类炎症性肿瘤,它补充了先前提出的基于肿瘤的分子簇。这些发现可能为探索针对生物标志物富集人群的新型免疫治疗方法提供理论依据,以提高GAC患者的生存率。
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