Tumor copy-number alterations predict response to immune-checkpoint-blockade in gastrointestinal cancer

Autor: Lin Shen, Huan Chen, Ming Lu, Shuang Li, Henghui Zhang, Jifang Gong, Zhihao Lu, Zhi Peng, Xi Jiao, Lihong Wu, Wenbo Han, Jianling Zou, Jianing Yu, Huaibo Sun
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal for ImmunoTherapy of Cancer, Vol 8, Iss 2 (2020)
Druh dokumentu: article
ISSN: 2051-1426
DOI: 10.1136/jitc-2019-000374
Popis: Background Despite the great achievements made in immune-checkpoint-blockade (ICB) in cancer therapy, there are no effective predictive biomarkers in gastrointestinal (GI) cancer.Methods This study included 93 metastatic GI patients treated with ICBs. The first cohort comprising 73 GI cancer patients were randomly assigned into discovery (n=44) and validation (n=29) cohorts. Comprehensive genomic profiling was performed on all samples to determine tumor mutational burden (TMB) and copy-number alterations (CNAs). A subset of samples was collected for RNA immune oncology (IO) panel sequencing, microsatellite instability (MSI)/mismatch repair and program death ligand 1 (PD-L1) expression evaluation. In addition, 20 gastric cancer (GC) patients were recruited as the second validation cohort.Results In the first cohort of 73 GI cancer patients, a lower burden of CNA was observed in patients with durable clinical benefit (DCB). In both the discovery (n=44) and validation (n=29) subsets, lower burden of CNA was associated with an improved clinical benefit and better overall survival (OS). Efficacy also correlated with a higher TMB. Of note, a combinatorial biomarker of TMB and CNA may better stratify DCB patients from ICB treatment, which was further confirmed in the second validation cohort of 20 GC patients. Finally, patients with lower burden of CNA revealed increased immune signatures in our cohort and The Cancer Genome Atlas data sets as well.Conclusions Our results suggest that the burden of CNA may have superior predictive value compared with other signatures, including PD-L1, MSI and TMB. The joint biomarker of CNA burden and TMB may better stratify DCB patients, thereby providing a rational choice for GI patients treated with ICBs.
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