Barroux Melissa, Househam Jacob, Lakatos Eszter, Ronel Tahel, Baker Ann-Marie, Salié Henrike, Mossner Maximilian, Smith Kane, Kimberley Chris, Nowinski Salpie, Berner Alison, Gunasri Vinaya, Borgmann Martin, Liffers Sven, Jansen Marnix, Caravagna Giulio, Steiger Katja, Slotta-Huspenina Julia, Weichert Wilko, Zapata Luis, Giota Eleftheria, Lorenzen Sylvie, Alberstmeier Markus, Chain Benny, Friess Helmut, Bengsch Bertram, Schmid Roland M, Siveke Jens T, Quante Michael, Graham Trevor A
Evolution and Cancer Laboratory, Centre for Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, UK.
Medical Clinic and Polyclinic II, TUM University Hospital, Klinikum rechts der Isar, Munich, Germany.
Nat Cancer. 2025 May 14. doi: 10.1038/s43018-025-00955-w.
Locally advanced esophageal adenocarcinoma remains difficult to treat and the ecological and evolutionary dynamics responsible for resistance and recurrence are incompletely understood. Here, we performed longitudinal multiomic analysis of patients with esophageal adenocarcinoma in the MEMORI trial. Multi-region multi-timepoint whole-exome and paired transcriptome sequencing was performed on 27 patients before, during and after neoadjuvant treatment. We found major transcriptomic changes during treatment with upregulation of immune, stromal and oncogenic pathways. Genetic data revealed that clonal sweeps through treatment were rare. Imaging mass cytometry and T cell receptor sequencing revealed remodeling of the tumor microenvironment during treatment. The presence of genetic immune escape, a less-cytotoxic T cell phenotype and a lack of clonal T cell expansions were linked to poor treatment response. In summary, there were widespread transcriptional and environmental changes through treatment, with limited clonal replacement, suggestive of phenotypic plasticity.
局部晚期食管腺癌的治疗仍然困难,导致耐药和复发的生态与进化动力学尚未完全明确。在此,我们在MEMORI试验中对食管腺癌患者进行了纵向多组学分析。对27例患者在新辅助治疗前、治疗期间和治疗后进行了多区域多时间点全外显子组和配对转录组测序。我们发现治疗期间免疫、基质和致癌途径上调,出现了主要的转录组变化。基因数据显示,治疗期间克隆性清除很少见。成像质谱流式细胞术和T细胞受体测序显示治疗期间肿瘤微环境发生重塑。基因免疫逃逸、细胞毒性较低的T细胞表型以及缺乏克隆性T细胞扩增与治疗反应不佳有关。总之,治疗过程中存在广泛的转录和环境变化,克隆替代有限,提示表型可塑性。