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.

Frontiers in Immunology
|August 15, 2022
PubMed
Abstract

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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