Plasma extracellular vesicle derived protein profile predicting and monitoring immunotherapeutic outcomes of gastric cancer.

Plasma extracellular vesicle derived protein profile predicting and monitoring immunotherapeutic outcomes of gastric cancer.
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血浆细胞外囊泡衍生的蛋白质谱预测和监测胃癌的免疫治疗结果

DOI:
10.1002/jev2.12209
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发表时间:
2022-04
影响因子:
16
通讯作者:
Shen L
Shen L
中科院分区:
医学2区
文献类型:
--
作者:
Zhang C;Chong X;Jiang F;Gao J;Chen Y;Jia K;Fan M;Liu X;An J;Li J;Zhang X;Shen L

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基于免疫检查点抑制剂(ICI)的免疫治疗为胃癌(GC)治疗带来了新的希望。然而,由于缺乏适当的生物标志物,GC免疫治疗的患者选择和结果预测仍然不能令人满意。在这项研究中,通过应用细胞外囊泡 (EV) 蛋白表达阵列,我们评估了血浆 EV 衍生蛋白谱与 ICI 相关治疗组合结果的相关性。将 112 名接受 ICI 相关治疗的 GC 患者的血浆分为三个队列进行回顾性/前瞻性研究。我们从 42 个关键候选蛋白中鉴定出四种血浆 EV 衍生蛋白 (ARG1/CD3/PD-L1/PD-L2),并将它们组合成 EV 评分,可以在基线时稳健预测免疫治疗结果,并动态监测治疗过程中的疾病进展。高EV分数反映了更强的抗肿瘤免疫的微环境特征,其特征是CD8+T/NK细胞活化更多、TH1/TH2比值更高以及配对外周血中IFN-γ/穿孔素/颗粒酶的表达更高,这些特征通过数据集分析和体内实验得到验证。 EV 分数≥1 GC 从 ICI 中获得更多治疗益处,而 EV 分数 < 1 GC 可能从 ICI 联合 HER2 靶向治疗中获益更多。总的来说,通过提出蛋白质水平的血浆 EV 评分,有力地预测和监测 GC 的免疫治疗结果,我们的工作促进了临床患者的选择和决策,并为免疫治疗相关的微环境变化和当前 ICI 方案的改进提供了机制见解。
Immune checkpoint inhibitor (ICI)‐based immunotherapy brought new hope for gastric cancer (GC) treatment. However, due to the lack of proper biomarkers, patient selection and outcome prediction for GC's immunotherapy remain unsatisfying. In this study, through applying an extracellular vesicle (EV) protein expression array, we assessed the correlation of plasma EV‐derived protein spectrum with outcomes of ICI‐related therapeutic combinations. Plasma from 112 GC patients received ICI‐related therapies were investigated retrospectively/prospectively as three cohorts. We identified four plasma EV‐derived proteins (ARG1/CD3/PD‐L1/PD‐L2) from 42 crucial candidate proteins and combined them as an EV‐score that robustly predicting immunotherapeutic outcomes at baseline and dynamically monitoring disease progression along with treatment. High EV‐score reflected microenvironmental features of stronger antitumour immunity, characterized by more activated CD8+ T/NK cells, higher TH1/TH2 ratio and higher expressions of IFN‐γ/perforin/granzymes in paired peripheral blood, which were verified by dataset analysis and in vivo experiments. EV‐score≥1 GC received more therapeutic benefits from ICIs, while EV‐score < 1 GC potentially benefited more from ICIs combining HER2‐targeted therapies. Collectively, through proposing a plasma EV‐score on protein level that powerfully predicting and monitoring GC's immunotherapeutic outcomes, our work facilitated clinical patient selection and decision‐makings, and provided mechanistical insights for immunotherapy‐related microenvironmental changes and improvements for current ICI‐regimens.
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