The Challenges of Tumor Mutational Burden as an Immunotherapy Biomarker.

The Challenges of Tumor Mutational Burden as an Immunotherapy Biomarker.
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DOI:
10.1016/j.ccell.2020.10.001
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发表时间:
2021-02-08
期刊:
影响因子:
50.3
通讯作者:
Kurzrock R
Kurzrock R
中科院分区:
医学1区
文献类型:
--
作者:
Jardim DL;Goodman A;de Melo Gagliato D;Kurzrock R

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肿瘤突变负荷(TMB)反映了癌症突变的数量。突变被加工成新抗原,并由主要组织相容性复合体(MHC)蛋白呈递给T细胞。为了逃避免疫根除,癌症利用抑制T细胞反应性的检查点。免疫检查点抑制剂(ICI)通过使T细胞重新激活改变了癌症治疗;然而,需要反应生物标志物,因为大多数患者没有受益。更高的TMB导致更多的新抗原,增加T细胞识别的机会,并在临床上与更好的ICI结果相关。然而,TMB是不完美的响应生物标志物。一个复合预测,也包括关键变量,如MHC和T细胞受体库,是必要的。
Tumor mutational burden (TMB) reflects cancer mutation quantity. Mutations are processed to neo-antigens and presented by major histocompatibility complex (MHC) proteins to T-cells. To evade immune eradication, cancers exploit checkpoints that dampen T-cell reactivity. Immune checkpoint inhibitors (ICIs) have transformed cancer treatment by enabling T-cell reactivation; however, response biomarkers are required, as most patients do not benefit. Higher TMB results in more neo-antigens, increasing chances for T-cell recognition, and clinically correlates with better ICI outcomes. Nevertheless, TMB is an imperfect response biomarker. A composite predictor that also includes critical variables, such as MHC and T-cell receptor repertoire, is needed.
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