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NOTCH4 mutation as predictive biomarker for immunotherapy benefits in NRAS wildtype melanoma
Hongxia Li1, Qin Zhang2,3,4, Qianqian Duan2,3,4
1Department of Oncology, Shanxi Provincial People's Hospital, Taiyuan, China.
Background:
NRAS wildtype melanoma accounts for approximately 80% of melanomas. Previous studies have shown that NRAS wildtype melanoma had higher response rates and better prognoses than NRAS-mutant patients following immunotherapy, while as major actors in tumor cells and tumor microenvironment (TME), the association between NOTCH family genes and response to immunotherapy in NRAS wildtype melanoma remains indistinct.
Objective:
We aim to explore whether NOTCH family gene variation is associated with genomic factors in immune checkpoint inhibitor (ICI) response in NRAS wildtype melanoma and with clinical results in these patients.
Method:
This research used genomic data of 265 NRAS wildtype ICI-pretreatment samples from five ICI-treated melanoma cohorts to analyze the relationship between NOTCH family gene mutation and the efficacy of ICI therapy.
Results:
NRAS wildtype melanomas with NOTCH4-Mut were identified to be associated with prolonged overall survival (OS) in both the discovery (HR: 0.30, 95% CI: 0.11-0.83, P = 0.01) and validation cohorts(HR: 0.21, 95% CI: 0.07-0.68, P = 0.003). Moreover, NOTCH4-Mut melanoma had a superior clinical response in the discovery cohort (ORR, 40.0% vs 13.11%, P = 0.057) and validation cohort (ORR, 68.75% vs 30.07%, P = 0.004). Further exploration found that NOTCH4-Mut tumors had higher tumor mutation burden (TMB) and tumor neoantigen burden (TNB) (P <0.05). NOTCH4-Mut tumors had a significantly increased mutation in the DNA damage response (DDR) pathway. Gene set enrichment analysis revealed NOTCH4-Mut tumor enhanced anti-tumor immunity.
Conclusion:
NOTCH4 mutation may promote tumor immunity and serve as a biomarker to predict good immune response in NRAS wildtype melanoma and guide immunotherapeutic responsiveness.
Insights
NOTCH4 mutations are linked to better outcomes in NRAS wildtype melanoma patients treated with immunotherapy. These mutations may enhance anti-tumor immunity and predict a stronger response to immune checkpoint inhibitors.
Area of Science:
- Oncology
- Immunology
- Genetics
Background:
- NRAS wildtype melanoma represents approximately 80% of melanoma cases.
- While NRAS wildtype melanoma generally shows better responses to immunotherapy than NRAS-mutant melanoma, the role of NOTCH family genes in this context is unclear.
- NOTCH family genes are critical in both tumor cells and the tumor microenvironment (TME).
Purpose of the Study:
- To investigate the association between NOTCH family gene variations and genomic factors influencing immune checkpoint inhibitor (ICI) response in NRAS wildtype melanoma.
- To evaluate the correlation between NOTCH family gene mutations and clinical outcomes in NRAS wildtype melanoma patients undergoing ICI therapy.
Main Methods:
- Genomic data from 265 NRAS wildtype, ICI-pre-treated melanoma samples across five cohorts were analyzed.
- The study assessed the relationship between NOTCH family gene mutations and the efficacy of ICI therapy.
Main Results:
- Melanomas with NOTCH4 mutations (NOTCH4-Mut) showed significantly prolonged overall survival (OS) in both discovery and validation cohorts.
- NOTCH4-Mut melanoma exhibited superior clinical response rates (ORR) compared to NOTCH4 wildtype.
- NOTCH4-Mut tumors displayed higher tumor mutation burden (TMB) and neoantigen burden (TNB), with increased mutations in the DNA damage response (DDR) pathway.
- Gene set enrichment analysis indicated enhanced anti-tumor immunity in NOTCH4-Mut tumors.
Conclusions:
- NOTCH4 mutations may enhance anti-tumor immunity in NRAS wildtype melanoma.
- NOTCH4 mutation status could serve as a predictive biomarker for favorable immune responses to ICI therapy.
- Identifying NOTCH4 mutations may help guide immunotherapeutic strategies in NRAS wildtype melanoma.
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