Targeted therapy and immunotherapy

靶向治疗和免疫治疗
  • 文章类型: Journal Article
    透明细胞肾细胞癌(ccRCC)是一种侵袭性恶性肿瘤。二硫化物凋亡是一种新的程序性细胞死亡机制,其特征在于对细胞具有高度毒性的细胞内二硫化物的异常积累。然而,目前还没有完全阐明二硫化物对ccRCC进展的贡献.在这项研究中,通过非负矩阵分解(NMF)算法在ccRCC患者中鉴定出两种不同的与二硫键下垂相关的分子亚型.簇1的特征在于较差的预后和较高的mRNAsi水平。然后,进行差异分析和加权基因共表达网络分析(WGCNA),以搜索与肿瘤干性和肿瘤微环境高度相关的模块基因。随后,通过WGCNA和最小绝对收缩和选择算子(LASSO)Cox回归分析逐步构建包含9个基因的SADG特征。高风险评分组的结果更差,免疫调节和代谢特征可能是高危人群癌症进展的原因。之后,构建了一个预测列线图,并使用三个独立的外部验证数据集验证了风险模型的预测能力。9个SADG显示与免疫浸润显着相关,肿瘤突变负荷(TMB),微卫星不稳定性(MSI)和免疫检查点。此外,基于单细胞RNA测序数据集(GSE139555),分析了9个hub基因在各类免疫细胞中的分布和表达。最后,通过qRT-PCR在临床样本中验证了9个基因的表达水平。
    Clear cell renal cell carcinoma (ccRCC) is an aggressive malignant tumor. Disulfidptosis is a new programmed cell death mechanism, which is characterized by the abnormal accumulation of intracellular disulfides that are highly toxic to cells. However, the contribution of disulfidptosis to ccRCC progression has not been fully clarified. In this study, two different molecular subtypes related to disulfidptosis were identified in ccRCC patients by the non-negative matrix factorization (NMF) algorithm. The cluster 1 was characterized by a worse prognosis and higher mRNAsi levels. Then, difference analysis and weighted gene co-expression network analysis (WGCNA) were conducted to search modular genes that are highly associated with tumor stemness and tumor microenvironment. Subsequently, a SADG signature containing nine genes was constructed stepwise by WGCNA and least absolute shrinkage and selection operator (LASSO) Cox regression analysis. The high-risk score group had a worse outcome, and immune regulation and metabolic signatures might be responsible for cancer progression in the high-risk group. After that, a predictive nomogram was constructed, and the predicting power of the risk model was verified using inter and three independent external validation datasets. Nine SADGs were shown to significantly correlate with immune infiltration, tumor mutation burden (TMB), microsatellite instability (MSI) and immune checkpoint. In addition, based on the single-cell RNA sequencing dataset (GSE139555), the distribution and expression of nine hub genes in various types of immune cells were analyzed. Finally, the expression level of the nine genes was verified in clinical samples by qRT-PCR.
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  • 文章类型: Journal Article
    背景:准确预测肿瘤分子改变对于优化癌症治疗至关重要。传统的基于组织的方法由于侵入性而受到限制,异质性,和分子动态变化。我们的目标是开发和验证深度学习影像组学框架,以获得反映各种分子变化的成像特征。帮助癌症患者的一线治疗决策。
    方法:我们进行了一项回顾性研究,包括来自三个机构的508名NSCLC患者,结合CT图像和临床病理数据。在3D肿瘤区域的三个数据源上构建了两个放射学评分和一个深度网络特征。使用这些功能,我们开发并验证了Deep-RadScore,一种用于预测预后因素的深度学习影像组学模型,基因突变,和免疫分子表达水平。
    结果:Deep-RadScore对肿瘤分子特征表现出强烈的辨别能力。在独立测试队列中,它实现了令人印象深刻的AUC:0.889的淋巴管浸润,胸膜侵犯0.903,T分期为0.894;EGFR和ALK为0.884,KRAS和PIK3CA为0.896,TP53为0.889,ROS1为0.895;PD-1/PD-L1为0.893。融合功能产生了最佳预测能力,超越任何单一的成像功能。相关性和可解释性分析证实了定制的深度网络特征在捕获超出已知放射学特征的其他成像表型方面的有效性。
    结论:这个概念验证框架表明,通过融合来自多个数据源的放射学特征和深度网络特征,可以提供跨成像特征和分子表型的新生物标志物。这具有为表征不同肿瘤分子改变的放射学表型提供有价值的见解的潜力。从而推进对NSCLC患者的非侵入性个性化治疗的追求。
    BACKGROUND: Accurate prediction of tumor molecular alterations is vital for optimizing cancer treatment. Traditional tissue-based approaches encounter limitations due to invasiveness, heterogeneity, and molecular dynamic changes. We aim to develop and validate a deep learning radiomics framework to obtain imaging features that reflect various molecular changes, aiding first-line treatment decisions for cancer patients.
    METHODS: We conducted a retrospective study involving 508 NSCLC patients from three institutions, incorporating CT images and clinicopathologic data. Two radiomic scores and a deep network feature were constructed on three data sources in the 3D tumor region. Using these features, we developed and validated the \'Deep-RadScore,\' a deep learning radiomics model to predict prognostic factors, gene mutations, and immune molecule expression levels.
    RESULTS: The Deep-RadScore exhibits strong discrimination for tumor molecular features. In the independent test cohort, it achieved impressive AUCs: 0.889 for lymphovascular invasion, 0.903 for pleural invasion, 0.894 for T staging; 0.884 for EGFR and ALK, 0.896 for KRAS and PIK3CA, 0.889 for TP53, 0.895 for ROS1; and 0.893 for PD-1/PD-L1. Fusing features yielded optimal predictive power, surpassing any single imaging feature. Correlation and interpretability analyses confirmed the effectiveness of customized deep network features in capturing additional imaging phenotypes beyond known radiomic features.
    CONCLUSIONS: This proof-of-concept framework demonstrates that new biomarkers across imaging features and molecular phenotypes can be provided by fusing radiomic features and deep network features from multiple data sources. This holds the potential to offer valuable insights for radiological phenotyping in characterizing diverse tumor molecular alterations, thereby advancing the pursuit of non-invasive personalized treatment for NSCLC patients.
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  • 文章类型: Journal Article
    胰腺导管腺癌(PDAC)由于缺乏早期诊断的方法或生物标志物及其对常规治疗方式的抵抗力,预后极差。靶向治疗,和免疫疗法。PDACs是一组异质性的恶性上皮肿瘤,具有不同的组织形态学模式和复杂的,异质遗传/分子景观。新提出的基于广泛基因组的PDAC分子分类,转录组,蛋白质组学和表观遗传学数据为这种致命疾病的分子异质性和侵袭性生物学提供了重要的见解。最近表征肿瘤微环境(TME)的研究揭示了肿瘤细胞与PDAC的免疫抑制TME之间的动态相互作用。这对疾病进展至关重要,以及它对化疗的抵抗力,新开发的靶向治疗和免疫疗法。迫切需要开发可在临床上用于为PDAC患者选择有效的个性化治疗的预测性标志物。在这次审查中,我们提供了PDAC的组织学和分子异质性和亚型的概述,以及它的前兆病变,免疫抑制TME,以及目前可用于患者的预测性分子标记。
    Pancreatic ductal adenocarcinoma (PDAC) has an extremely poor prognosis due to the lack of methods or biomarkers for early diagnosis and its resistance to conventional treatment modalities, targeted therapies, and immunotherapies. PDACs are a heterogenous group of malignant epithelial neoplasms with various histomorphological patterns and complex, heterogenous genetic/molecular landscapes. The newly proposed molecular classifications of PDAC based on extensive genomic, transcriptomic, proteomic and epigenetic data have provided significant insights into the molecular heterogeneity and aggressive biology of this deadly disease. Recent studies characterizing the tumor microenvironment (TME) have shed light on the dynamic interplays between the tumor cells and the immunosuppressive TME of PDAC, which is essential to disease progression, as well as its resistance to chemotherapy, newly developed targeted therapy and immunotherapy. There is a critical need for the development of predictive markers that can be clinically utilized to select effective personalized therapies for PDAC patients. In this review, we provide an overview of the histological and molecular heterogeneity and subtypes of PDAC, as well as its precursor lesions, immunosuppressive TME, and currently available predictive molecular markers for patients.
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  • 文章类型: Journal Article
    高通量下一代测序(NGS)提供了对全基因组突变的见解,可用于识别预测免疫和靶向反应的生物标志物。需要对遗传变异和有效干预措施的分子生物学意义有更深入的了解,并最终需要与临床益处相关联。我们对两个在“真实世界”环境中接受NGS的癌症患者进行了回顾性观察研究。评估了肿瘤突变负荷(TMB)差异与临床表现之间的关联。我们旨在鉴定几个关键突变靶标,并描述它们的生物学特征和潜在的临床价值。下载泛癌症数据集作为进一步分析和总结的验证集。还实现了针对关键标志物的靶向干预的天然产物筛选。大多数肿瘤患者是患有晚期癌症的年轻成年男性。鉴定出突变率最高的基因是TP53,其次是PIK3CA,EGFR,LRP1B确定了TMB(0-103.7muts/Mb)与各种临床亚组的关联。更频繁的突变,例如在LRP1B中,以及高水平的铁蛋白和神经元特异性烯醇化酶,导致更高的TMB水平。进一步分析重点目标,LRP1B和APC,被执行,与APC相比,LRP1B的突变导致更好的免疫益处。APC,胃肠道肿瘤中最常见的突变基因之一,被进一步调查,并阐明了CochinchinoneB和rottlerin的潜在干预措施。总之,基于对“真实世界”中基因突变特征的分析,“我们获得了TMB的潜在关联指标,找到了密钥签名LRP1B和APC,并进一步描述了它们的生物学意义和潜在的干预措施。
    High-throughput next-generation sequencing (NGS) provides insights into genome-wide mutations and can be used to identify biomarkers for the prediction of immune and targeted responses. A deeper understanding of the molecular biological significance of genetic variation and effective interventions is required and ultimately needs to be associated with clinical benefits. We conducted a retrospective observational study of patients in two cancer cohorts who underwent NGS in a \"real-world\" setting. The association between differences in tumor mutational burden (TMB) and clinical presentation was evaluated. We aimed to identify several key mutation targets and describe their biological characteristics and potential clinical value. A pan-cancer dataset was downloaded as a verification set for further analysis and summary. Natural product screening for the targeted intervention of key markers was also achieved. The majority of tumor patients were younger adult males with advanced cancer. The gene identified with the highest mutation rate was TP53, followed by PIK3CA, EGFR, and LRP1B. The association of TMB (0-103.7 muts/Mb) with various clinical subgroups was determined. More frequent mutations, such as in LRP1B, as well as higher levels of ferritin and neuron-specific enolase, led to higher TMB levels. Further analysis of the key targets, LRP1B and APC, was performed, and mutations in LRP1B led to better immune benefits compared to APC. APC, one of the most frequently mutated genes in gastrointestinal tumors, was further investigated, and the potential interventions by cochinchinone B and rottlerin were clarified. In summary, based on the analysis of the characteristics of gene mutations in the \"real world,\" we obtained the potential association indicators of TMB, found the key signatures LRP1B and APC, and further described their biological significance and potential interventions.
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