lung adenocarcinoma

肺腺癌
  • 文章类型: Journal Article
    背景:肺癌是癌症相关死亡的主要原因,是所有恶性肿瘤中发病率和死亡率最高的肿瘤之一。据报道,DEPDC1B的表达失调发生在各种肿瘤类型中。然而,这种改变在肺腺癌(LUAD)中的功能意义和潜在的分子机制尚不清楚.在这项研究中,我们研究了DEPDC1B在LUAD中的作用和临床意义。
    方法:在几个公开可用的数据集中系统评估了DEPDC1B在LUAD中的表达及其与预后的关系。DEPDC1B敲低对LUAD细胞增殖和运动的影响使用JULI阶段实时细胞历史记录,同时通过流式细胞术研究敲低对细胞周期的影响。此外,进行RNA测序(RNA-Seq)分析以鉴定由DEPDC1B调节的下游靶基因和途径。DEPDC1B的表达与免疫细胞浸润的相关性,免疫疗法抗性,还检查了化学抗性。此外,采用分子生物学方法探讨B-Myb对DEPDC1B表达的调控机制。
    结果:发现DEPDC1B在LUAD患者中上调,这与不良临床结局相关。敲除DEPDC1B抑制细胞生长,迁移和运动性,以及细胞周期进程。敲除还导致几个下游基因的下调,包括NID1、FN1和EGFR,以及多个关键途径的失活,如ERK和PI3K-AKT途径。对LUAD中肿瘤免疫环境的分析表明,高DEPDC1B表达与大量活化的CD4记忆T细胞有关,M0巨噬细胞,M1巨噬细胞,和CD8+T细胞。此外,这些肿瘤对免疫疗法的反应较差.化疗药物敏感性分析显示,DEPDC1B高表达的LUADs对长春瑞滨等一线化疗药物反应更敏感,顺铂,和依托泊苷。此外,机制研究表明,DEPDC1B是B-Myb的直接靶基因,并且其敲除减弱了B-Myb的增殖和运动作用。
    结论:总之,我们的研究结果表明,DEPDC1B是LUAD恶性进展过程中的关键调节因子.因此,DEPDC1B可能是LUAD诊断和治疗中一个有前途的预后标志物和治疗靶标。
    BACKGROUND: Lung cancer is the primary cause of cancer-related deaths, with one of the highest incidence and mortality rates of all malignant tumors. Dysregulated expression of DEPDC1B has been reported to occur in various tumor types. However, the functional implications of this alteration in lung adenocarcinoma (LUAD) and the underlying molecular mechanism remains unclear. In this study, we investigated the role and clinical significance of DEPDC1B in LUAD.
    METHODS: The expression of DEPDC1B in LUAD and its relationship with prognosis were systematically evaluated in several publically available datasets. The effects of DEPDC1B knockdown on the proliferation and motility of LUAD cells were assessed using the JULI Stage Real-time Cell History Recorder, while the effect of knockdown on the cell cycle was studied by flow cytometry. Furthermore, RNA-Sequencing (RNA-Seq) analysis was conducted to identify the downstream target genes and pathways regulated by DEPDC1B. Correlations between the expression of DEPDC1B and immune cell infiltration, immunotherapy resistance, and chemoresistance were also examined. Additionally, molecular biological methods were used to explore the regulatory mechanism of B-Myb on DEPDC1B expression.
    RESULTS: DEPDC1B was found to be upregulated in LUAD patients and this was associated with poor clinical outcomes. Knockdown of DEPDC1B inhibited cell growth, migration and motility, as well as cell cycle progression. Knockdown also resulted in the down-regulation of several downstream genes, including NID1, FN1, and EGFR, as well as the inactivation of multiple critical pathways, such as the ERK and PI3K-AKT pathways. Analysis of the tumor immuno-environment in LUAD revealed that high DEPDC1B expression was associated with an abundance of activated CD4+ memory T cells, M0 macrophages, M1 macrophages, and CD8+ T cells. Moreover, these tumors responded poorly to immunotherapy. Analysis of chemo-drug sensitivity showed that LUADs with high DEPDC1B expression were more responsive to frontline chemotherapeutic drugs such as Vinorelbine, Cisplatin, and Etoposide. Additionally, mechanistic investigations revealed that DEPDC1B is a direct target gene of B-Myb, and that its knockdown attenuated the proliferation and motility effects of B-Myb.
    CONCLUSIONS: In summary, our findings indicate that DEPDC1B is a critical regulator during the malignant progression of LUAD. DEPDC1B could therefore be a promising prognostic marker and therapeutic target in LUAD diagnosis and treatment.
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  • 文章类型: Journal Article
    肺腺癌(LUAD)患者通常预后不良。目前,关于LUAD非整倍体相关基因的预后和免疫治疗能力的研究有限。
    使用Spearman方法基于来自公共数据库的大量RNA测序数据筛选与非整倍体相关的基因。接下来,进行单变量Cox和Lasso回归分析,以建立非整倍体相关风险评分(ARS)模型.使用细胞实验进一步验证来自生物信息学分析的结果。此外,通过亚型聚类鉴定典型的LUAD细胞,其次是场景和细胞间通讯分析。最后,估计,采用ssGSEA和CIBERSORT算法分析ARS与肿瘤免疫环境之间的潜在关系。
    开发了五基因ARS签名。这些基因在LUAD细胞系中异常高表达,特别是CKS1B的高表达促进了细胞增殖,LUAD细胞系的迁移和侵袭表型。低ARS组总体生存时间较长,炎症浸润程度较高,并且可以从接受免疫疗法中受益更多。低ASR组患者对传统化疗药物(厄洛替尼和Roscovitine)反应更积极。scRNA-seq剖析注解17个细胞亚群分为7个细胞簇。核心转录因子(TFs)如CREB3L1和CEBPD在高ARS细胞组中富集,而BCLAF1和UQCRB等TFs在低ARS细胞组中富集。CellChat分析显示,高ARS细胞群通过SPP1(ITGA4-ITGB1)和MK(MDK-NCl)信号通路与免疫细胞沟通。
    在这项研究中,基于ARS模型的综合分析为改善LUAD的诊断和治疗提供了潜在的方向。
    UNASSIGNED: Patients with lung adenocarcinoma (LUAD) often develop a poor prognosis. Currently, researches on prognostic and immunotherapeutic capacity of aneuploidy-related genes in LUAD are limited.
    UNASSIGNED: Genes related to aneuploidy were screened based on bulk RNA sequencing data from public databases using Spearman method. Next, univariate Cox and Lasso regression analyses were performed to establish an aneuploidy-related riskscore (ARS) model. Results derived from bioinformatics analysis were further validated using cellular experiments. In addition, typical LUAD cells were identified by subtype clustering, followed by SCENIC and intercellular communication analyses. Finally, ESTIMATE, ssGSEA and CIBERSORT algorithms were employed to analyze the potential relationship between ARS and tumor immune environment.
    UNASSIGNED: A five-gene ARS signature was developed. These genes were abnormally high-expressed in LUAD cell lines, and in particular the high expression of CKS1B promoted the proliferative, migratory and invasive phenotypes of LUAD cell lines. Low ARS group had longer overall survival time, higher degrees of inflammatory infiltration, and could benefit more from receiving immunotherapy. Patients in low ASR group responded more actively to traditional chemotherapy drugs (Erlotinib and Roscovitine). The scRNA-seq analysis annotated 17 cell subpopulations into seven cell clusters. Core transcription factors (TFs) such as CREB3L1 and CEBPD were enriched in high ARS cell group, while TFs such as BCLAF1 and UQCRB were enriched in low ARS cell group. CellChat analysis revealed that high ARS cell groups communicated with immune cells via SPP1 (ITGA4-ITGB1) and MK (MDK-NCl) signaling pathways.
    UNASSIGNED: In this research, integrative analysis based on the ARS model provided a potential direction for improving the diagnosis and treatment of LUAD.
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  • 文章类型: Journal Article
    UBA5,一种泛素样活化酶,参与ufmylation和sumoylation,为胰腺癌和乳腺癌的治疗提供了一个可行的目标,然而,其在肺腺癌(LUAD)中的作用仍未得到充分研究。这项研究揭示了UBA5在LUAD中的肿瘤促进作用,正如其在患者中的上调以及与TNM分期呈正相关所证明的那样。UBA5水平升高可预测这些患者的不良预后。使用DKM2-93对UBA5的药理学抑制在体外显着抑制了A549,H1299和顺铂抗性A549(A549/DDP)LUAD细胞的生长。此外,通过shRNA慢病毒的UBA5敲低在体外和体内抑制肿瘤生长。UBA5的高表达会对肿瘤免疫微环境产生不利影响,影响免疫刺激剂,MHC分子,趋化因子,受体,和免疫细胞浸润。值得注意的是,UBA5表达与M2巨噬细胞浸润呈正相关,LUAD中的主要免疫细胞。共培养实验进一步证明UBA5敲低直接抑制LUAD中的M2巨噬细胞极化和乳酸产生。此外,体内研究显示UBA5敲低后M2巨噬细胞浸润减少。UBA5表达也与肿瘤异质性增加有关,包括肿瘤突变负担,微卫星不稳定,新抗原的存在,和同源重组缺陷。实验表明UBA5过表达在体外促进顺铂耐药,而UBA5抑制增强顺铂在体外和体内设置的敏感性。总的来说,这些发现表明,靶向UBA5通过阻止癌细胞增殖来抑制LUAD,M2巨噬细胞极化,和顺铂耐药。
    UBA5, a ubiquitin-like activated enzyme involved in ufmylation and sumoylation, presents a viable target for pancreatic and breast cancer treatments, yet its role in lung adenocarcinoma (LUAD) remains underexplored. This study reveals UBA5\'s tumor-promoting effect in LUAD, as evidenced by its upregulation in patients and positive correlation with TNM stages. Elevated UBA5 levels predict poor outcomes for these patients. Pharmacological inhibition of UBA5 using DKM 2-93 significantly curtails the growth of A549, H1299, and cisplatin-resistant A549 (A549/DDP) LUAD cells in vitro. Additionally, UBA5 knockdown via shRNA lentivirus suppresses tumor growth both in vitro and in vivo. High UBA5 expression adversely alters the tumor immune microenvironment, affecting immunostimulators, MHC molecules, chemokines, receptors, and immune cell infiltration. Notably, UBA5 expression correlates positively with M2 macrophage infiltration, the predominant immune cells in LUAD. Co-culture experiments further demonstrate that UBA5 knockdown directly inhibits M2 macrophage polarization and lactate production in LUAD. Moreover, in vivo studies show reduced M2 macrophage infiltration following UBA5 knockdown. UBA5 expression is also associated with increased tumor heterogeneity, including tumor mutational burden, microsatellite instability, neoantigen presence, and homologous recombination deficiency. Experiments indicate that UBA5 overexpression promotes cisplatin resistance in vitro, whereas UBA5 inhibition enhances cisplatin sensitivity in both in vitro and in vivo settings. Overall, these findings suggest that targeting UBA5 inhibits LUAD by impeding cancer cell proliferation, M2 macrophage polarization, and cisplatin resistance.
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  • 文章类型: Journal Article
    肺腺癌(LUAD)具有高度侵袭性并且易于转移的恶性特征。仍然缺乏合适的生物标志物来促进基于精确的治疗方案的改进。我们使用10种已知的聚类算法和来自4个维度的组学数据的组合来鉴定LUAD的高分辨率分子亚型。随后,基于亚型相关基因和包含10种机器学习算法的集成程序框架,开发了共识机器学习相关预后签名(CMRS).从肿瘤微环境的角度分析了CMRS的效率,基因组景观,免疫疗法,药物敏感性,和单细胞分析。在结果方面,通过多组学聚类,我们确定了2种综合组学亚型(CSs),其中CS1患者的生存结局较差,更高的侵略性,mRNAsi和突变频率。随后,我们基于CS1中上调的13个关键基因开发了CMRS。CMRS的预后预测效率优于大多数已建立的LUAD预后特征。CMRS显示出与肿瘤微环境特征变异和基因组不稳定性产生的强相关性。关于临床表现,高CMRS组的患者更有可能从免疫治疗中获益,而低CMRS更有可能从化疗和靶向药物治疗中获益.此外,我们评估了neratinib等药物,寡霉素A,和其他人可能是高CMRS组患者的候选人。单细胞分析显示CMRS相关基因主要在上皮细胞中表达。在这项研究中基于多组学数据确定的新分子亚型可以为LUAD的分层治疗提供新的见解,而CMRS的发展可以作为LUAD精准治疗和免疫治疗获益程度的候选指标.
    Lung adenocarcinoma (LUAD) has a malignant characteristic that is highly aggressive and prone to metastasis. There is still a lack of suitable biomarkers to facilitate the refinement of precision-based therapeutic regimens. We used a combination of 10 known clustering algorithms and the omics data from 4 dimensions to identify high-resolution molecular subtypes of LUAD. Subsequently, consensus machine learning-related prognostic signature (CMRS) was developed based on subtypes related genes and an integrated program framework containing 10 machine learning algorithms. The efficiency of CMRS was analyzed from the perspectives of tumor microenvironment, genomic landscape, immunotherapy, drug sensitivity, and single-cell analysis. In terms of results, through multi-omics clustering, we identified 2 comprehensive omics subtypes (CSs) in which CS1 patients had worse survival outcomes, higher aggressiveness, mRNAsi and mutation frequency. Subsequently, we developed CMRS based on 13 key genes up-regulated in CS1. The prognostic predictive efficiency of CMRS was superior to most established LUAD prognostic signatures. CMRS demonstrated a strong correlation with tumor microenvironmental feature variants and genomic instability generation. Regarding clinical performance, patients in the high CMRS group were more likely to benefit from immunotherapy, whereas low CMRS were more likely to benefit from chemotherapy and targeted drug therapy. In addition, we evaluated that drugs such as neratinib, oligomycin A, and others may be candidates for patients in the high CMRS group. Single-cell analysis revealed that CMRS-related genes were mainly expressed in epithelial cells. The novel molecular subtypes identified in this study based on multi-omics data could provide new insights into the stratified treatment of LUAD, while the development of CMRS could serve as a candidate indicator of the degree of benefit of precision therapy and immunotherapy for LUAD.
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  • 文章类型: Journal Article
    (1)背景:GHaK是由抗菌肽temporin-Gha通过用K取代氨基酸H来增强其杀菌活性而衍生的。本研究旨在通过探索GHaK对人肺腺癌的抗肿瘤活性来拓宽其药理潜力。(2)方法:细胞活力,迁移,入侵,凋亡,GHaK处理后检测A549和PC-9细胞的细胞周期。miRNA测序,RT-PCR,西方印迹,和荧光素酶报告基因检测进一步揭示了潜在的机制。(3)结果:GHaK显著抑制细胞活力,迁移,和侵袭;诱导凋亡;并导致PC-9和A549细胞在G2/M和S期的细胞周期停滞,分别。miRNA测序结果显示总共161个上调的miRNA和115个下调的miRNA。此外,该研究确定了六个上调的miRNA(miR-4516,miR-4284,miR-204-5p,miR-12136、miR-4463和miR-1296-3p)及其对靶基因表达的抑制作用(Wnt8B,FZD2,DVL3和FOSL1)由miR-4516直接与Wnt8B相互作用引起。Western印迹显示p-GSK-3β的下调,A549细胞中细胞周期蛋白A1和CDK2的表达以及PC-9细胞中细胞周期蛋白B1和CDK1的表达降低。(4)结论:Temporin-GHaK通过miRNA-4516抑制Wnt信号通路对人肺腺癌具有抗肿瘤活性。
    (1) Background: GHaK is derived from the antimicrobial peptide temporin-GHa by substituting the amino acid H with K to enhance its bactericidal activity. The present research aims to broaden the pharmacological potential of GHaK by exploring its antineoplastic activity against human lung adenocarcinoma. (2) Methods: The cell viability, migration, invasion, apoptosis, and cell cycle of A549 and PC-9 cells were tested after GHaK treatment. miRNA sequencing, RT-PCR, Western blotting, and luciferase reporter gene assay were further performed to reveal the potential mechanism. (3) Results: GHaK significantly suppressed cell viability, migration, and invasion; induced apoptosis; and caused cell cycle arrest in the G2/M and S phase in PC-9 and A549 cells, respectively. The miRNA sequencing results show a total of 161 up-regulated and 115 down-regulated miRNAs. Furthermore, the study identified six up-regulated miRNAs (miR-4516, miR-4284, miR-204-5p, miR-12136, miR-4463, and miR-1296-3p) and their inhibitory effects on the expressions of target genes (Wnt 8B, FZD2, DVL3, and FOSL1) caused by miR-4516 directly interacting with Wnt 8B. Western blotting revealed the down-regulation of p-GSK-3β, along with a decreased expressions of cyclin A1 and CDK2 in A549 cells and cyclin B1 and CDK1 in PC-9 cells. (4) Conclusions: Temporin-GHaK exhibits antineoplastic activity against human lung adenocarcinoma by inhibiting the Wnt signaling pathway through miRNA-4516.
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  • 文章类型: Journal Article
    这项研究的目的是评估循环活性和非活性IL-18水平在区分接受免疫检查点抑制剂治疗(ICIs)的NSCLC患者中假性和真实肿瘤进展中的潜在价值。
    方法:这项辅助研究包括195名接受ICI单药治疗的转移性非小细胞肺癌(NSCLC)患者,pembrolizumab或nivolumab。IL-18相关化合物的血浆水平,包含抑制剂IL-18结合蛋白(IL-18BP),无活性的IL-18(对应于IL-18/IL-18BP复合物),和活性游离IL-18通过ELISA测定。基线时通过18FDGPET-CT分析客观肿瘤反应,7周,治疗诱导后3个月,使用PERCIST标准。
    结果:与健康对照相比,非小细胞肺癌患者血浆IL-18BP和总IL-18水平在基线时升高,而IL-18/IL-18BP复合物减少,和游离IL-18水平保持不变。IL-18相关化合物均不允许区分对无反应患者有反应的ICI。然而,不活跃的IL-18水平允许区分第一次肿瘤进展的患者,治疗7周后评估,总体生存率较差。此外,我们发现中性粒细胞浓度也是OS(HR=2.6,p=0.0001)和PFS(HR=2.2,p=0.001)患者结局的预测指标.
    结论:无活性IL-18的血浆水平,结合循环中性粒细胞浓度,能有效区分ICI无反应患者,总生存期(OS)更好,可能指导治疗强化的快速决策。
    The aim of this study was to assess the potential value of circulating active and inactive IL-18 levels in distinguishing pseudo and true tumor progression among NSCLC patients receiving immune checkpoint inhibitor treatments (ICIs).
    METHODS: This ancillary study includes 195 patients with metastatic non-small-cell lung cancer (NSCLC) treated with ICI in monotherapy, either pembrolizumab or nivolumab. Plasmatic levels of IL-18-related compounds, comprising the inhibitor IL-18 binding protein (IL-18BP), the inactive IL-18 (corresponding to IL-18/IL-18BP complex), and the active free IL-18, were assayed by ELISA. Objective tumoral response was analyzed by 18FDG PET-CT at baseline, 7 weeks, and 3 months post treatment induction, using PERCIST criteria.
    RESULTS: Plasmatic IL-18BP and total IL-18 levels are increased at baseline in NSCLC patients compared with healthy controls, whereas IL-18/IL-18BP complexes are decreased, and free IL-18 levels remain unchanged. Neither of the IL-18-related compounds allowed to discriminate ICI responding to nonresponding patients. However, inactive IL-18 levels allowed to discriminate patients with a first tumor progression, assessed after 7 weeks of treatment, with worse overall survival. In addition, we showed that neutrophil concentration is also a predictive indicator of patients\' outcomes with OS (HR = 2.6, p = 0.0001) and PFS (HR = 2.2, p = 0.001).
    CONCLUSIONS: Plasmatic levels of inactive IL-18, combined with circulating neutrophil concentrations, can effectively distinguish ICI nonresponding patients with better overall survival (OS), potentially guiding rapid decisions for therapeutic intensification.
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  • 文章类型: Journal Article
    我们旨在探索与铂类治疗和多胺代谢相关的基因是否可以预测LUAD的预后。我们搜索了与基于铂的治疗相关的差异表达基因(DEGs),然后我们将它们与多胺代谢相关基因相互作用以获得hub基因。随后,我们使用scRNA-seq数据分析了LUAD中的主要免疫细胞群体,并评价了不同细胞亚群的多胺代谢活性。筛选高、低活动组之间的DEGs,找出关键的DEGs,建立预后风险评分模型。我们进一步阐明了免疫细胞的景观,不同风险组的突变和药物敏感性分析。最后,我们得到了10个与铂类化疗和多胺代谢相关的hub基因,并发现这些hub基因主要影响信号传导途径。B细胞和肥大细胞具有最高的多胺代谢活性,而根据scRNA-seq数据发现NK细胞的多胺代谢活性最低。确定了高和低多胺代谢活性组之间的DEG,然后筛选出6个关键基因建立风险评分,显示出良好的预测能力。风险评分与免疫疗法检查点基因和细胞毒性T细胞浸润呈普遍负相关。低危组EGFR突变率明显高于高危组。总之,我们根据与铂类治疗和多胺代谢相关的关键基因制定了风险评分,为LUAD的预后预测提供了新的视角。
    We aimed to explore whether the genes associated with both platinum-based therapy and polyamine metabolism could predict the prognosis of LUAD. We searched for the differential expression genes (DEGs) associated with platinum-based therapy, then we interacted them with polyamine metabolism-related genes to obtain hub genes. Subsequently, we analysed the main immune cell populations in LUAD using the scRNA-seq data, and evaluated the activity of polyamine metabolism of different cell subpopulations. The DEGs between high and low activity groups were screened to identify key DEGs to establish prognostic risk score model. We further elucidated the landscape of immune cells, mutation and drug sensitivity analysis in different risk groups. Finally, we got 10 hub genes associated with both platinum-based chemotherapy and polyamine metabolism, and found that these hub genes mainly affected signalling transduction pathways. B cells and mast cells with highest polyamine metabolism activity, while NK cells were found with lowest polyamine metabolism activity based on scRNA-seq data. DEGs between high and low polyamine metabolism activity groups were identified, then 6 key genes were screened out to build risk score, which showed a good predictive power. The risk score showed a universal negative correlation with immunotherapy checkpoint genes and the cytotoxic T cells infiltration. The mutation rates of EGFR in low-risk group was significantly higher than that of high-risk group. In conclusion, we developed a risk score based on key genes associated with platinum-based therapy and polyamine metabolism, which provide a new perspective for prognosis prediction of LUAD.
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  • 文章类型: Journal Article
    早期肺癌现在更常见于毛玻璃结节(GGNs)的形式。目前,GGNs治疗肺癌主要依靠手术治疗;然而,由于随访标准不统一,仍然存在过度治疗和延迟治疗等问题。因此,非侵入性治疗的发现可以扩大磨玻璃结节状肺癌的治疗范围,有利于患者的预后.免疫疗法最近已成为肺癌治疗领域中一种新的有希望的方法。因此,本研究对GGNs肺癌的免疫微环境进行了全面综述,并描述了所涉及的各种免疫细胞的功能和特征,旨在为新型免疫治疗靶点的临床鉴定提供指导。
    Early-stage lung cancer is now more commonly identified in the form of ground-glass nodules (GGNs). Presently, the treatment of lung cancer with GGNs mainly depends on surgery; however, issues still exist such as overtreatment and delayed treatment due to the nonuniform standard of follow-up. Therefore, the discovery of a noninvasive treatment could expand the treatment repertoire of ground-glass nodular lung cancer and benefit the prognosis of patients. Immunotherapy has recently emerged as a new promising approach in the field of lung cancer treatment. Thus, this study presents a comprehensive review of the immune microenvironment of lung cancer with GGNs and describes the functions and characteristics of various immune cells involved, aiming to provide guidance for the clinical identification of novel immunotherapeutic targets.
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  • 文章类型: Journal Article
    目的:HER2是非小细胞肺癌(NSCLC)中罕见突变的驱动基因。目前,尚无全面的大规模临床研究来确定HER2突变体晚期肺腺癌(LUAD)的最佳一线治疗策略.除此之外,吡唑替尼的有效性和安全性,泛HER抑制剂,在NSCLC的背景下仍在研究中。
    方法:在本研究中,我们对2014年5月至2023年6月期间接受一线治疗和吡罗替尼治疗的HER2突变晚期LUAD进行了回顾性数据收集.接受化疗的患者,化疗+免疫检查点抑制剂(ICIs),化疗+贝伐单抗和吡罗替尼的一线治疗.此外,我们收集了这些患者疾病进展后使用吡唑替尼的疗效和安全性数据.研究的主要终点是无进展生存期(PFS)。
    结果:在最终分析中,89例患者纳入一线队列,30例患者纳入吡唑替尼队列。在一线治疗队列中,化疗+ICIs,化疗+贝伐单抗,与化疗相比,吡唑替尼表现出显著的生存获益(中位PFS:9.87vs.7.77vs.7.10vs.5.40个月,p值<0.05)。此外,一线治疗PFS少于6个月的患者可能会从随后的pyrotinib治疗中受益(中位PFS:7.467vs.3.000,p值=0.0490)。
    结论:在HER2突变体LUAD的一线治疗中,涉及化疗+ICIs等组合的方案,化疗+贝伐单抗,与化疗相比,吡唑替尼可能具有增强的生存优势。然而,在这三种治疗策略中没有观察到明显的区别,强调必须识别生物标志物,以辨别选择合适的治疗方式。此外,一线治疗疗效欠佳的患者可能会从吡罗替尼获得更多益处.
    OBJECTIVE: HER2 is an infrequently mutated driver gene in non-small cell lung cancer (NSCLC). At present, there has been no comprehensive large-scale clinical study to establish the optimal first-line treatment strategy for advanced lung adenocarcinoma (LUAD) with HER2-Mutant. Besides that, the effectiveness and safety of pyrotinib, a pan-HER inhibitor, in the context of NSCLC are still undergoing investigation.
    METHODS: In this study, we conducted a retrospective data collection of HER2-Mutated advanced LUAD who received first-line treatment and pyrotinib between May 2014 and June 2023. Patients treated with chemotherapy, chemotherapy + immune checkpoint inhibitors (ICIs), chemotherapy + bevacizumab and pyrotinib in first-line treatment. Furthermore, we collected data on the efficacy and safety of pyrotinib in these patients after disease progression. The main endpoint of the study was progression-free survival (PFS).
    RESULTS: In the final analysis, 89 patients were included in the first-line cohort and 30 patients were included in the pyrotinib cohort. In the first-line treatment cohort, chemotherapy + ICIs, chemotherapy + bevacizumab, and pyrotinib exhibited notable survival benefits compared to chemotherapy (median PFS: 9.87 vs. 7.77 vs. 7.10 vs. 5.40 months, p-value < 0.05). Furthermore, patients with a first-line treatment PFS of less than 6 months may potentially benefit from subsequent treatment with pyrotinib (median PFS: 7.467 vs. 3.000, p-value = 0.0490).
    CONCLUSIONS: In the first-line treatment of HER2-Mutant LUAD, regimens involving combinations like chemotherapy + ICIs, chemotherapy + bevacizumab, and pyrotinib may confer enhanced survival advantages compared to chemotherapy. Nevertheless, no significant distinctions were observed among these three treatment strategies, underscoring the imperative to identify biomarkers for the discerning selection of suitable therapeutic modalities. Moreover, patients with suboptimal response to first-line treatment may potentially derive more benefit from pyrotinib.
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  • 文章类型: Journal Article
    根据线粒体能量代谢和免疫疗法敏感性确定肺腺癌(LUAD)患者的亚型对于精准癌症治疗至关重要。
    使用无监督共识聚类识别LUAD亚型,并对结果进行免疫和肿瘤突变分析.通过差异分析鉴定亚型之间的DEGs。进行了功能富集和PPI网络分析。根据前10个hub基因的表达将患者分为高表达组和低表达组,并进行生存分析。根据hub基因表达与药物IC50值的相关性筛选对特征基因敏感的药物。qRT-PCR和westernblot用于基因表达检测,CCK-8和流式细胞术用于细胞活力和凋亡分析。
    Cluster-1具有明显更高的总生存率和更高的免疫浸润和免疫表型评分,但是潮汐得分较低,深度得分,和TMB。富集分析表明,两个簇之间的DEGs通路和功能主要与受体配体与细胞内蛋白酶的相互作用有关。hub基因的高表达对应于较低的患者存活率。对特征基因敏感性较高的预测药物为CDK1:利巴韦林(0.476),CCNB2:羟基脲(0.474),白屈菜红碱(0.470),和KIF11:利巴韦林(0.471)。KIF11和CCNB2在LUAD细胞中高表达,促进细胞活力,抑制细胞凋亡。
    这项研究确定了LUAD的两个亚型,Cluster-1更适合免疫治疗。本研究结果为LUAD患者的精准免疫治疗提供了参考。
    UNASSIGNED: Identifying subtypes of lung adenocarcinoma (LUAD) patients based on mitochondrial energy metabolism and immunotherapy sensitivity is essential for precision cancer treatment.
    UNASSIGNED: LUAD subtypes were identified using unsupervised consensus clustering, and results were subjected to immune and tumor mutation analyses. DEGs between subtypes were identified by differential analysis. Functional enrichment and PPI network analyses were conducted. Patients were classified into high and low expression groups based on the expression of the top 10 hub genes, and survival analysis was performed. Drugs sensitive to feature genes were screened based on the correlation between hub gene expression and drug IC50 value. qRT-PCR and western blot were used for gene expression detection, and CCK-8 and flow cytometry were for cell viability and apoptosis analysis.
    UNASSIGNED: Cluster-1 had significantly higher overall survival and a higher degree of immunoinfiltration and immunophenotypic score, but a lower TIDE score, DEPTH score, and TMB. Enrichment analysis showed that pathways and functions of DEGs between two clusters were mainly related to the interaction of receptor ligands with intracellular proteases. High expression of hub genes corresponded to lower patient survival rates. The predicted drugs with high sensitivity to feature genes were CDK1: Ribavirin (0.476), CCNB2: Hydroxyurea (0.474), Chelerythrine (0.470), and KIF11: Ribavirin (0.471). KIF11 and CCNB2 were highly expressed in LUAD cells and promoted cell viability and inhibited cell apoptosis.
    UNASSIGNED: This study identified two subtypes of LUAD, with cluster-1 being more suitable for immunotherapy. These results provided a reference for the development of precision immunotherapy for LUAD patients.
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