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在免疫治疗的背景下,黑色素瘤到狂宫肌肉瘤的可塑性
Andrew D Knight1,2, Emily J Robitschek3, Jia-Ren Lin4
1Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
medRxiv : the preprint server for health sciences
|November 24, 2025
概括
黑色素瘤中对免疫检查点抑制剂 (ICI) 获得的耐药性可能涉及表型可塑性. 一名患者从黑色素瘤中发展出肌肉骨髓瘤 (RMS),尽管有共同的起源,但显示出不同的遗传和分子概况.
科学领域:
- 在瘤学瘤学.
- 癌症生物学 癌症生物学
- 遗传学 是一个遗传学.
背景情况:
- 对免疫检查点抑制剂 (ICI) 的获得性耐药性是转移性黑色素瘤治疗的主要障碍.
- 现型可塑性,包括去差异化和转差异化,与治疗耐药性有关.
- 了解耐药机制对于改善黑色素瘤治疗至关重要.
研究的目的:
- 在转移性黑色素瘤中调查一种罕见的获得ICI耐药性的病例.
- 分析从黑色素瘤转变为狂宫肌肉瘤 (RMS) 的表型转换的遗传和分子基础.
- 描述与治疗出现的RMS相关的瘤微环境.
主要方法:
- 纵向瘤样本的全外体测序 (WES) 和RNA测序 (RNA-seq).
- 高复合组织成像 (空间蛋白质组学) 用于分析瘤微环境.
- 遗传学分析以确定克隆进化和分歧.
主要成果:
- 共同的驱动突变 (NRAS,NF1) 和异构性丧失 (LOH) 证实了一种共同的祖先黑色素瘤克隆.
- 观察到表型的早期分歧,每个血统都获得了不同的突变.
- RNA-seq揭示了相互排斥的谱系标记物和表皮细胞-介质细胞过渡和RMS中的肌源性基因组的丰富.
- 空间蛋白质组学确定了不同的瘤微环境,其中RMS病变显示了CD163+巨细胞的丰富.
结论:
- 现型可塑性可以驱动转移性黑色素瘤中对ICI的获得性耐药性,从而导致RMS等独特瘤类型的出现.
- 综合基因组和蛋白质组分析对于剖析复杂的抵抗机制至关重要.
- 向特定的瘤微环境可能为抗性黑色素瘤提供新的治疗策略.
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