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Xu M, Zhao X, Wen T, Qu X. Unveiling the role of KRAS in tumor immune microenvironment. Biomed Pharmacother 2024; 171:116058. [PMID: 38171240 DOI: 10.1016/j.biopha.2023.116058] [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: 10/09/2023] [Revised: 12/03/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
Kirsten rats sarcoma viral oncogene (KRAS), the first discovered human oncogene, has long been recognized as "undruggable". KRAS mutations frequently occur in multiple human cancers including non-small cell lung cancer(NSCLC), colorectal cancer(CRC) and pancreatic ductal adenocarcinoma(PDAC), functioning as a "molecule switch" determining the activation of various oncogenic signaling pathways. Except for its intrinsic pro-tumorigenic role, KRAS alteration also exhibits an unique immune signature characterized by elevated PD-L1 level and high tumor mutational burden(TMB). KRAS mutation shape an immune suppressive microenvironment by impeding effective T cells infiltration and recruiting suppressive immune cells including myeloid-derived suppressor cells(MDSCs), regulatory T cells(Tregs), cancer associated fibroblasts(CAFs). In immune checkpoint inhibitor(ICI) era, NSCLC patients with mutated KRAS tend to be more responsive to ICI than patients with intact KRAS. The hallmark for KRAS mutation is the existence of multiple kinds of co-mutations. Different types of co-alterations have distinct tumor microenvironment(TME) signatures and responses to ICI. TP53 co-mutation possess a "hot" TME and achieve higher response to immunotherapy while other loss of function mutation correlated with a "colder" TME and a poor outcome to ICI-based therapy. The groundbreaking discovery of KRAS G12C inhibitors significantly improved outcomes for this KRAS subtype even though efficacy was limited to NSCLC patients. KRAS G12C inhibitors also restore the suppressive TME, creating an opportunity for combinations with ICI. However, an inevitable challenge to KRAS inhibitors is drug resistance. Promising combination strategies such as combination with SHP2 is an approach deserve further exploration because of their immune modulatory effect.
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Affiliation(s)
- Miao Xu
- Department of Medical Oncology, the First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning, China; Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Provinces, The First Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Cancer Research Center of Shenyang, the First Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, Shenyang, Liaoning, China
| | - Xing Zhao
- Department of Pediatrics, the First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning, China
| | - Ti Wen
- Department of Medical Oncology, the First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning, China; Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Provinces, The First Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Cancer Research Center of Shenyang, the First Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, Shenyang, Liaoning, China
| | - Xiujuan Qu
- Department of Medical Oncology, the First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning, China; Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Provinces, The First Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Cancer Research Center of Shenyang, the First Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, Shenyang, Liaoning, China.
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Du Y, Lin Y, Wang B, Li Y, Xu D, Gan L, Xiong X, Hou S, Chen S, Shen Z, Ye Y. Cuproptosis patterns and tumor immune infiltration characterization in colorectal cancer. Front Genet 2022; 13:976007. [PMID: 36176287 PMCID: PMC9513614 DOI: 10.3389/fgene.2022.976007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Faced with the high heterogeneity and poor prognosis of colorectal cancer (CRC), this study sought to find new predictive prognostic strategies to improve the situation. Cuproptosis is a novel cell death mechanism that relies on copper regulation. However, the role of cuproptosis-related gene (CRG) in CRC remains to be elucidated. In this study, we comprehensively assessed the CRG landscape in CRC based on The Cancer Genome Atlas (TCGA). We identified differential expression and genetic alterations of CRG in CRC. CRG is highly correlated with initiation, progression, prognosis, and immune infiltration of CRC. We construct a risk score signature containing 3 CRGs based on LASSO. We explored the correlation of CRG-Score with clinicopathological features of CRC. Age, stage, and CRG-Score were integrated to construct a nomogram. The nomogram has robust predictive performance. We also understand the correlation of CRG-Score with CRC immune landscape. CRG-Score can effectively predict the immune landscape of CRC patients. Low-risk CRC patients have greater immunogenicity and higher immune checkpoint expression. Low-risk CRC patients may be better candidates for immunotherapy. At the same time, we also predicted more sensitive drugs in the high-risk CRC patients. In conclusion, the CRG risk score signature is a strong prognostic marker and may help provide new insights into the treatment of individuals with CRC.
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Affiliation(s)
- Yan Du
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
| | - Yilin Lin
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
| | - Bo Wang
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
| | - Yang Li
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
| | - Duo Xu
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
| | - Lin Gan
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
| | - Xiaoyu Xiong
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
| | - Sen Hou
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
| | - Shuang Chen
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
| | - Zhanlong Shen
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
- Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
- *Correspondence: Yingjiang Ye, ; Zhanlong Shen,
| | - Yingjiang Ye
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People’s Hospital, Beijing, China
- Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
- *Correspondence: Yingjiang Ye, ; Zhanlong Shen,
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