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Tumor microenvironment evaluation promotes precise checkpoint immunotherapy of advanced gastric cancer.

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机构: [1]Department of Oncology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China [2]State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China [3]Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China [4]Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China [5]Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China [6]Department of Medical Oncology, Phase I Clinical Trial Centre, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China [7]Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA [8]Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China [9]Karolinska Institutet Department of Medicine-Solna, Clinical Pharmacology Group, Karolinska University Hospital, Stockholm, Sweden [10]Department of Pathology and Translational Genomics, Samsung Medical Center, Gangnam-gu, Seoul, South Korea
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Durable efficacy of immune checkpoint blockade (ICB) occurred in a small number of patients with metastatic gastric cancer (mGC) and the determinant biomarker of response to ICB remains unclear.We developed an open-source TMEscore R package, to quantify the tumor microenvironment (TME) to aid in addressing this dilemma. Two advanced gastric cancer cohorts (RNAseq, N=45 and NanoString, N=48) and other advanced cancer (N=534) treated with ICB were leveraged to investigate the predictive value of TMEscore. Simultaneously, multi-omics data from The Cancer Genome Atlas of Stomach Adenocarcinoma (TCGA-STAD) and Asian Cancer Research Group (ACRG) were interrogated for underlying mechanisms.The predictive capacity of TMEscore was corroborated in patient with mGC cohorts treated with pembrolizumab in a prospective phase 2 clinical trial (NCT02589496, N=45, area under the curve (AUC)=0.891). Notably, TMEscore, which has a larger AUC than programmed death-ligand 1 combined positive score, tumor mutation burden, microsatellite instability, and Epstein-Barr virus, was also validated in the multicenter advanced gastric cancer cohort using NanoString technology (N=48, AUC=0.877). Exploration of the intrinsic mechanisms of TMEscore with TCGA and ACRG multi-omics data identified TME pertinent mechanisms including mutations, metabolism pathways, and epigenetic features.Current study highlighted the promising predictive value of TMEscore for patients with mGC. Exploration of TME in multi-omics gastric cancer data may provide the impetus for precision immunotherapy.© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

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出版当年[2020]版:
大类 | 1 区 医学
小类 | 1 区 免疫学 2 区 肿瘤学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 免疫学 2 区 肿瘤学
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出版当年[2019]版:
Q1 ONCOLOGY Q1 IMMUNOLOGY
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Q1 IMMUNOLOGY Q1 ONCOLOGY

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第一作者机构: [1]Department of Oncology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
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