RAS/BRAF V600E突变对瘤免疫微环境的影响,在不匹配修复缺陷/微卫星不稳定性,结肠直肠癌等情况下
Mohamed E Salem1, Alberto Puccini2, Elizabeth Mauer3
1Levine Cancer Institute, Charlotte, United States.
概括
在不匹配修复缺陷结直肠癌 (dMMR CRC) 中的RAS突变与瘤免疫性降低有关. 这些瘤在瘤免疫微环境 (TiME) 中表现出较少的炎症和较少的CD8+T细胞.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 遗传学 是一个遗传学.
背景情况:
- 不匹配修复缺陷结直肠癌 (dMMR CRC) 需要进行常规测试,以对林奇综合征进行查,预后和治疗.
- RAS和BRAF突变对于转移性CRC的治疗决策至关重要.
- 尚不清楚RAS/BRAF突变对dMMRCRC中的瘤免疫微环境 (TiME) 的影响.
研究的目的:
- 研究RAS和BRAF突变对瘤免疫微环境 (TiME) 在不匹配修复缺陷结直肠癌 (dMMR CRC) 的影响.
- 为了比较不同突变状态 (RASmut,BRAFV600E和野生型) 的dMMRCRC瘤的免疫性和炎症概况.
主要方法:
- 对448名患有I-IV期dMMRCRC的患者进行了回顾性分析.
- 对瘤突变负担 (TMB) 和瘤新抗原负担 (NTB) 的下一代测序 (NGS).
- 针对dMMR,PD-L1表达和免疫细胞透 (包括CD8+T细胞) 的免疫组织化学 (IHC).
主要成果:
- 在22%的dMMRCRC病例中发现了RAS突变 (RASmut),27%的BRAFV600E,51%是双野生型 (RASwt,BRAFwt).
- 与BRAFV600E和野生型瘤相比,RASmut瘤的NTB和PD-L1表达显著降低.
- 拉斯穆特dMMRCRC中的TiME显示整体炎症减少,CD8+T细胞透率比野生型或BRAFV600E瘤少.
结论:
- 与野生型或BRAFV600E瘤相比,具有RAS突变的MSI/dMMRCRCs具有较低的免疫性,TiME炎症较小.
- 这些发现表明基于dMMRCRC中的RAS/BRAF突变状态的独特免疫特征.
- 需要进一步验证以确认这些免疫原性差异及其临床影响.
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