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Usta SZ, Uchihashi T, Kodama S, Kurioka K, Inubushi T, Shimooka T, Sugauchi A, Seki S, Tanaka S. Current Status and Molecular Mechanisms of Resistance to Immunotherapy in Oral Malignant Melanoma. Int J Mol Sci 2023; 24:17282. [PMID: 38139110 PMCID: PMC10743423 DOI: 10.3390/ijms242417282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/19/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs), including anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and anti-programmed death-1 (PD-1) antibodies, have initiated a new era in the treatment of malignant melanoma. ICIs can be used in various settings, including first-line, adjuvant, and neo-adjuvant therapy. In the scope of this review, we examined clinical studies utilizing ICIs in the context of treating oral mucosal melanoma, a rare disease, albeit with an extremely poor prognosis, with a specific focus on unraveling the intricate web of resistance mechanisms. The absence of a comprehensive review focusing on ICIs in oral mucosal melanoma is notable. Therefore, this review seeks to address this deficiency by offering a novel and thorough analysis of the current status, potential resistance mechanisms, and future prospects of applying ICIs specifically to oral malignant melanoma. Clarifying and thoroughly understanding these mechanisms will facilitate the advancement of effective therapeutic approaches and enhance the prospects for patients suffering from oral mucosal melanoma.
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Affiliation(s)
- Sena Zeynep Usta
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Osaka, Japan; (S.Z.U.); (S.K.); (K.K.); (T.S.); (A.S.); (S.S.); (S.T.)
| | - Toshihiro Uchihashi
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Osaka, Japan; (S.Z.U.); (S.K.); (K.K.); (T.S.); (A.S.); (S.S.); (S.T.)
| | - Shingo Kodama
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Osaka, Japan; (S.Z.U.); (S.K.); (K.K.); (T.S.); (A.S.); (S.S.); (S.T.)
| | - Kyoko Kurioka
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Osaka, Japan; (S.Z.U.); (S.K.); (K.K.); (T.S.); (A.S.); (S.S.); (S.T.)
| | - Toshihiro Inubushi
- Department of Orthodontics & Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita 565-0871, Osaka, Japan;
| | - Takuya Shimooka
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Osaka, Japan; (S.Z.U.); (S.K.); (K.K.); (T.S.); (A.S.); (S.S.); (S.T.)
| | - Akinari Sugauchi
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Osaka, Japan; (S.Z.U.); (S.K.); (K.K.); (T.S.); (A.S.); (S.S.); (S.T.)
- Unit of Dentistry, Osaka University Hospital, 2-15, Yamadaoka, Suita 565-0871, Osaka, Japan
| | - Soju Seki
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Osaka, Japan; (S.Z.U.); (S.K.); (K.K.); (T.S.); (A.S.); (S.S.); (S.T.)
| | - Susumu Tanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita 565-0871, Osaka, Japan; (S.Z.U.); (S.K.); (K.K.); (T.S.); (A.S.); (S.S.); (S.T.)
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Ishino T, Kawashima S, Tanji E, Ueno T, Ueda Y, Ogasawara S, Sato K, Mano H, Ishihara S, Kato N, Kawazu M, Togashi Y. Somatic mutations can induce a noninflamed tumour microenvironment via their original gene functions, despite deriving neoantigens. Br J Cancer 2023; 128:1166-1175. [PMID: 36732592 PMCID: PMC10006227 DOI: 10.1038/s41416-023-02165-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Identifying biomarkers to predict immune checkpoint inhibitor (ICI) efficacy is warranted. Considering that somatic mutation-derived neoantigens induce strong immune responses, patients with a high tumour mutational burden reportedly tend to respond to ICIs. However, there are several conflicting data. Therefore, we focused on the original function of neoantigenic mutations and their impact on the tumour microenvironment (TME). METHODS We evaluated 88 high-frequency microsatellite instability (MSI-H) colorectal cancers and analysed the function of the identified neoantigenic mutations and their influence on programmed cell death 1 (PD-1) blockade efficacy. The results were validated using The Cancer Genome Atlas (TCGA) datasets. RESULTS We identified frameshift mutations in RNF43 as a common neoantigenic gene mutation in MSI-H tumours. However, loss-of-function RNF43 mutations induced noninflamed TME by activating the WNT/β-catenin signalling pathway. In addition, loss of RNF43 function induced resistance to PD-1 blockade even in neoantigen-rich tumours. TCGA dataset analyses demonstrated that passenger rather than driver gene mutations were related to the inflamed TME in diverse cancer types. CONCLUSIONS We propose a novel concept of "paradoxical neoantigenic mutations" that can induce noninflamed TME through their original gene functions, despite deriving neoantigens, suggesting the significance of qualities as well as quantities in neoantigenic mutations.
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Affiliation(s)
- Takamasa Ishino
- Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.,Division of Cell Therapy, Chiba Cancer Center Research Institute, 666-2, Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan.,Department of Gastroenterology, Graduate School of Medicine, Chiba University, 1‑8‑1 Inohana, Chuo‑ku, Chiba, 260‑8670, Japan
| | - Shusuke Kawashima
- Division of Cell Therapy, Chiba Cancer Center Research Institute, 666-2, Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan.,Department of Dermatology, Graduate School of Medicine, Chiba University, 1‑8‑1 Inohana, Chuo‑ku, Chiba, 260‑8670, Japan
| | - Etsuko Tanji
- Division of Cell Therapy, Chiba Cancer Center Research Institute, 666-2, Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan
| | - Toshihide Ueno
- Division of Cellular Signaling, National Cancer Center Research Institute; 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Youki Ueda
- Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Sadahisa Ogasawara
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, 1‑8‑1 Inohana, Chuo‑ku, Chiba, 260‑8670, Japan
| | - Kazuhito Sato
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Mano
- Division of Cellular Signaling, National Cancer Center Research Institute; 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Naoya Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, 1‑8‑1 Inohana, Chuo‑ku, Chiba, 260‑8670, Japan
| | - Masahito Kawazu
- Division of Cell Therapy, Chiba Cancer Center Research Institute, 666-2, Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan. .,Division of Cellular Signaling, National Cancer Center Research Institute; 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Yosuke Togashi
- Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. .,Division of Cell Therapy, Chiba Cancer Center Research Institute, 666-2, Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan.
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