Molecular Subsets in Renal Cancer Determine Outcome to Checkpoint and Angiogenesis Blockade.

Molecular Subsets in Renal Cancer Determine Outcome to Checkpoint and Angiogenesis Blockade.
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肾癌中的分子亚群确定了检查点和血管生成阻滞的结果。

DOI:
10.1016/j.ccell.2020.10.011
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发表时间:
2020-12-14
期刊:
影响因子:
50.3
通讯作者:
Rini B
Rini B
中科院分区:
医学1区
文献类型:
--
作者:
Motzer RJ;Banchereau R;Hamidi H;Powles T;McDermott D;Atkins MB;Escudier B;Liu LF;Leng N;Abbas AR;Fan J;Koeppen H;Lin J;Carroll S;Hashimoto K;Mariathasan S;Green M;Tayama D;Hegde PS;Schiff C;Huseni MA;Rini B

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对来自晚期肾细胞癌 (RCC) 患者的 823 例肿瘤进行综合多组学评估,确定了与单独血管生成阻断或联合检查点抑制剂的不同临床结果相关的分子亚群。无监督的转录组分析揭示了七个具有不同血管生成、免疫、细胞周期、代谢和基质程序的分子子集。虽然舒尼替尼和阿特珠单抗+贝伐单抗在高血管生成的亚群中有效,但阿特珠单抗+贝伐单抗可改善具有高 T 效应子和/或细胞周期转录的肿瘤的临床获益。 PBRM1 和 KDM5C 的体细胞突变与高血管生成和 AMPK/脂肪酸氧化基因表达相关,而 CDKN2A/B 和 TP53 的改变与细胞周期和合成代谢升高相关。肉瘤样肿瘤表现出 PBRM1 突变和血管生成标记物的发生率较低、CDKN2A/B 频繁改变以及 PD-L1 表达增加。这些发现可应用于对患者进行分子分层,解释检查点阻断与单独使用抗血管生成药物相比肉瘤样肿瘤的改善结果,并开发针对肾细胞癌和其他适应症的个性化治疗。莫泽尔等人。对一项随机临床试验中的 823 个肾癌肿瘤进行综合多组学分析。基于转录和基因改变谱以及单独 VEGF 阻断或与抗 PD-L1 组合的不同临床结果的强大分子分类方案,为 RCC 的个性化治疗策略和未来治疗开发提供信息。
Integrated multi-omics evaluation of 823 tumors from advanced renal cell carcinoma (RCC) patients identifies molecular subsets associated with differential clinical outcomes to angiogenesis blockade alone or with a checkpoint inhibitor. Unsupervised transcriptomic analysis reveals seven molecular subsets with distinct angiogenesis, immune, cell cycle, metabolism, and stromal programs. While sunitinib and atezolizumab+bevacizumab are effective in subsets with high angiogenesis, atezolizumab+bevacizumab improves clinical benefit in tumors with high T-effector and/or cell cycle transcription. Somatic mutations in PBRM1 and KDM5C associate with high angiogenesis and AMPK/Fatty acid oxidation gene expression, while CDKN2A/B and TP53 alterations associate with elevated cell cycle and anabolic metabolism. Sarcomatoid tumors exhibit lower prevalence of PBRM1 mutations and angiogenesis markers, frequent CDKN2A/B alterations, and increased PD-L1 expression. These findings can be applied to molecularly stratify patients, explain improved outcomes of sarcomatoid tumors to checkpoint blockade vs. anti-angiogenics alone, and develop personalized therapies in RCC and other indications. Motzer et al. perform integrative multi-omics analyses of 823 renal cancer tumors from a randomized clinical trial. A robust molecular classification scheme, based on transcriptional and gene alteration profiles and differential clinical outcomes to VEGF blockade alone or in combination with anti-PD-L1, informs personalized treatment strategies and future therapeutic development in RCC.
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