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| Pàgina inicial > Articles > Articles publicats > Tumor microenvironment gene expression profiles associated to complete pathological response and disease progression in resectable NSCLC patients treated with neoadjuvant chemoimmunotherapy |
(Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana) (Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana) (Institut d'Investigació Biomèdica de Bellvitge) (Hospital Clínic Universitari (València)) (Complejo Hospitalario Universitario de A Coruña) (Hospital Universitario de Vigo) (Hospital Universitario Fundación Jiménez Díaz) (Institut d'Investigació Biomèdica Sant Pau) (Hospital Universitario Insular de Gran Canaria) (Vall d'Hebron Institut d'Oncologia) (Hospital Universitario La Paz (Madrid)) (Instituto de Investigación Biomédica de Málaga) (Hospital Universitario de Cruces (Barakaldo, País Basc)) (Hospital Universitario de Salamanca) (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia)) (Hospital Clínic i Provincial de Barcelona) (Hospital Universitario Reina Sofía (Còrdova, Espanya)) (Hospital General Universitario de Alicante (Alacant, País Valencià)) (Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana) (Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana) (Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana) (Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana) (Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana) (Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana) (Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana)
| Data: | 2022 |
| Resum: | Background Neoadjuvant chemoimmunotherapy for non-small cell lung cancer (NSCLC) has improved pathological responses and survival rates compared with chemotherapy alone, leading to Food and Drug Administration (FDA) approval of nivolumab plus chemotherapy for resectable stage IB-IIIA NSCLC (AJCC 7th edition) without ALK or EGFR alterations. Unfortunately, a considerable percentage of tumors do not completely respond to therapy, which has been associated with early disease progression. So far, it is impossible to predict these events due to lack of knowledge. In this study, we characterized the gene expression profile of tumor samples to identify new biomarkers and mechanisms behind tumor responses to neoadjuvant chemoimmunotherapy and disease recurrence after surgery. Methods Tumor bulk RNA sequencing was performed in 16 pretreatment and 36 post-treatment tissue samples from 41 patients with resectable stage IIIA NSCLC treated with neoadjuvant chemoimmunotherapy from NADIM trial. A panel targeting 395 genes related to immunological processes was used. Tumors were classified as complete pathological response (CPR) and non-CPR, based on the total absence of viable tumor cells in tumor bed and lymph nodes tested at surgery. Differential-expressed genes between groups and pathway enrichment analysis were assessed using DESeq2 and gene set enrichment analysis. CIBERSORTx was used to estimate the proportions of immune cell subtypes. Results CPR tumors had a stronger pre-established immune infiltrate at baseline than non-CPR, characterized by higher levels of IFNG, GZMB, NKG7, and M1 macrophages, all with a significant area under the receiver operating characteristic curve (ROC) >0. 9 for CPR prediction. A greater effect of neoadjuvant therapy was also seen in CPR tumors with a reduction of tumor markers and IFNγsignaling after treatment. Additionally, the higher expression of several genes, including AKT1, BST2, OAS3, or CD8B; or higher dendritic cells and neutrophils proportions in post-treatment non-CPR samples, were associated with relapse after surgery. Also, high pretreatment PD-L1 and tumor mutational burden levels influenced the post-treatment immune landscape with the downregulation of proliferation markers and type I interferon signaling molecules in surgery samples. Conclusions Our results reinforce the differences between CPR and non-CPR responses, describing possible response and relapse immune mechanisms, opening the possibility of therapy personalization of immunotherapy-based regimens in the neoadjuvant setting of NSCLC. |
| Ajuts: | Instituto de Salud Carlos III PI19/01652 Instituto de Salud Carlos III CD19/00170 Ministerio de Ciencia e Innovación RTC2017-6502-1 Ministerio de Ciencia e Innovación RTC2019-007359-1 European Commission. Horizon 2020 875160 |
| Nota: | Altres ajuts: European Regional Development Fund (ERDF/FEDER); Bristol-Myers Squibb (BMS); Spanish Lung Cancer Group (SLCG) grant; Comunidad de Madrid (PEJD-2019-PRE/BMD-17006). |
| Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.  |
| Llengua: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Publicat a: | Journal for immunotherapy of cancer, Vol. 10 Núm. 9 (september 2022) , p. e005320, ISSN 2051-1426 |
