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A Distinct Innate Immune Signature of Early Onset Colorectal Cancer.

Ivy H Gardner1, Ragavan Siddharthan1, Katherine Watson1

  • 1Department of Surgery, Oregon Health & Science University, Portland, OR.

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Summary

Early onset colorectal cancer (CRC) shows a distinct immune microenvironment compared to late onset CRC. This unique immune signature, particularly involving genes like CFD and SAA1, is linked to poorer patient survival outcomes.

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Area of Science:

  • Oncology
  • Immunology
  • Cancer Research

Background:

  • Colorectal cancer (CRC) prevalence is decreasing overall, but rising in individuals under 50.
  • Early-onset CRC (≤50 years) and late-onset CRC (≥65 years) exhibit differences in clinicopathological and genetic features.
  • The immune microenvironment's role in early-onset CRC progression remains unclear.

Purpose of the Study:

  • To investigate potential differences in the immune microenvironment between early-onset and late-onset CRC.
  • To determine if the immune microenvironment contributes to tumor progression in early-onset CRC.

Main Methods:

  • NanoString immune profiling of mRNA expression in surgical specimens from 40 early-onset and 39 late-onset CRC patients.
  • Analysis of immune gene expression, focusing on differences between early and late onset groups.
  • Gain-of-function experiments with specific genes (CFD, SAA1) in subcutaneous tumor models.

Main Results:

  • Three genes (SAA1, C7, CFD) showed increased expression in early-onset CRC, with distinct immune signatures based on tumor location.
  • Increased expression of CFD and SAA1 correlated with worse progression-free survival.
  • Elevated C7 expression was associated with worse overall survival.
  • CFD gain-of-function experiments led to higher tumor volumes and altered immune gene expression in mouse models.

Conclusions:

  • Early-onset CRC possesses a unique immune microenvironment characterized by a distinct innate immune response signature.
  • This immune microenvironment is dependent on tumor location and may contribute to worse patient outcomes.
  • Specific genes like CFD and SAA1 play a role in early-onset CRC progression and survival.