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Genetic and transcriptional insights into immune checkpoint blockade response and survival: lessons from melanoma and beyond

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机构: [1]Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing 100853, China. [2]Department of Pathology, Beidahuang Industry Group General Hospital, Harbin 150088, China. [3]Geneseeq Research Institute, Nanjing Geneseeq Technology Inc, Nanjing 210032, China. [4]Department of Pathology, Lanzhou University Second Hospital, Lanzhou 730030, China. [5]Department of Scientific Affairs, Mabwell (Shanghai) Biotech Co., Ltd., Beijing, China. [6]Day Care Ward, Tianjin Cancer Hospital Airport Hospital, Tianjin 300000, China. [7]Department of Thoracic Surgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China.
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关键词: Immune checkpoint inhibitor Clinical response Biomarker DNAH Gene expression

摘要:
Integration of immune checkpoint inhibitors (ICIs) with non-immune therapies relies on identifying combinatorial biomarkers, which are essential for patient stratification and personalized treatment.We analyzed genomic and transcriptomic data from pretreatment tumor samples of 342 melanoma patients treated with ICIs to identify mutations and expression signatures associated with ICI response and survival. External validation and mechanistic exploratory analyses were conducted in two additional datasets to assess generalizability.Responders were more likely to have received anti-PD-1 therapy rather than anti-CTLA-4 and exhibited a higher tumor mutation burden (both P < 0.001). Mutations in the dynein axonemal heavy chain (DNAH) family genes, specifically DNAH2 (P = 0.03), DNAH6 (P < 0.001), and DNAH9 (P < 0.01), were enriched in responders. The combined mutational status of DNAH 2/6/9 effectively stratified patients by progression-free survival (hazard ratio [HR]: 0.69; 95% confidence interval [CI] 0.51-0.92; P = 0.013) and overall survival (HR: 0.58; 95% CI 0.43-0.78; P < 0.001), with consistent association observed in the validation cohort (HR: 0.28; 95% CI 0.12-0.61; P < 0.001). DNAH-altered melanomas exhibited upregulation of chemokine signaling, cytokine-cytokine receptor interaction, and cell cycle-related pathways, along with elevated expression of immune-related signatures in interferon signaling, cytolytic activity, T cell function, and immune checkpoints. Using LASSO logistic regression, we identified a 26-gene composite signature predictive of clinical response, achieving an area under the curve (AUC) of 0.880 (95% CI 0.825-0.936) in the training dataset and 0.725 (95% CI 0.595-0.856) in the testing dataset. High-risk patients, stratified by the expression levels of a 13-gene signature, demonstrated significantly shorter overall survival in both datasets (HR: 3.35; P < 0.001; HR: 2.93; P = 0.002).This analysis identified potential molecular determinants of response and survival to ICI treatment. Insights from melanoma biomarker research hold significant promise for translation into other malignancies, guiding individualized anti-tumor immunotherapy.© 2025. The Author(s).

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出版当年[2025]版:
大类 | 2 区 医学
小类 | 2 区 医学:研究与实验
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 医学:研究与实验
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第一作者机构: [1]Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing 100853, China.
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