大规模的癌症基因组分析揭示了微卫星不稳定性和瘤突变负担之间的显著差异
Jungyoon Choi1, Kyong Hwa Park2, Yeul Hong Kim2
1Division of Oncology/Hematology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
概括
微卫星不稳定性高 (MSI-H) 和瘤突变负担高 (TMB-H) 是癌症免疫治疗的关键生物标志物. 这项研究揭示了MSI-H和TMB-H之间的差异,表明联合生物标志物可以改善肺癌免疫疗法预测.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 微卫星不稳定性 (MSI) 和瘤突变负担 (TMB) 是已确立的泛癌免疫疗法的预测生物标志物.
- 高MSI (MSI-H) 和高TMB (TMB-H) 现型之间的确切关系以及它们在肺癌免疫治疗中的联合预测效用仍然不完全理解.
研究的目的:
- 调查MSI-H和TMB-H在各种人类癌症之间的相互关系.
- 评估MSI-H和TMB-H的预测价值,单独和组合,用于肺癌免疫治疗反应.
主要方法:
- 通过基因组学证据瘤信息交换,分析了46320名患者的体质突变数据.
- 使用调整的多变量回归模型来评估MSI-H和TMB-H关系.
- 采用Cox的比例危险模型来检查患者的生存率和MSI与遗传突变之间的关联.
主要成果:
- 显著比例的MSI-H患者 (31-89%) 在22种癌症类型中表现出TMB低的表型,突出了差异.
- 与低TMB患者相比,接受免疫治疗的TMB-H肺癌患者的整体存活率和无进展存活率有所改善.
- 结合的TMB和MSI表型进一步提高了生存结果;在MSI-H表型中发现了ARID1A和ARID1B等新型突变基因.
结论:
- TMB-H和/或MSI-H作为有价值的生物标志物,用于预测免疫治疗在肺癌中的疗效.
- 针对免疫疗法选择,建议采用不同的或结合的生物标志物策略,因为在不同癌症类型中观察到MSI-H和TMB-H之间的差异.
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