Integrated analysis of molecular and clinical features associated with overall survival in melanoma patients with brain metastasis.

IF 6.2 2区 医学 Q1 NEUROSCIENCES
Swaminathan Kumar, Meredith S Pelster, Merve Hasanov, Renato A Guerrieri, Courtney W Hudgens, Debora A Ledesma, Fuchenchu Wang, Grant M Fischer, Julie M Simon, Lauren E Haydu, Kalman V Katlowitz, Y N Vashisht Gopal, Jennifer L McQuade, Lawrence N Kwong, Jason T Huse, Alexander J Lazar, Michael T Tetzlaff, Jeffrey E Gershenwald, Aron Y Joon, Ken Chen, Ziyi Li, Prahlad T Ram, Sherise D Ferguson, Michael A Davies
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引用次数: 0

Abstract

Melanoma brain metastases (MBMs) are diagnosed in up to 60% of metastatic melanoma patients. Previous studies have identified clinical factors that correlate with overall survival (OS) after MBM diagnosis. However, molecular and immune features associated with OS are poorly understood. An improved understanding of the molecular and immune correlates of OS could provide insights into MBM patient outcomes and guide therapeutic development. Thus, we analyzed clinical features and outcomes of 74 melanoma patients who underwent surgical resection (via craniotomy) between 1991 and 2015 at our institution with RNA-seq data generated from their MBMs. The median post-operative OS was 8.6 months (range 0.6-146.9). On univariate analysis (UVA), the expression of multiple immune gene signatures was associated with improved OS, including IFN-γ Index, T cell-inflamed and the Expanded Immune Genes. The gene expression signatures of several immune cell types (i.e., T cells, CD8 T cells, cytotoxic lymphocytes, NK cells, monocytes) positively correlated with OS, whereas higher neutrophil gene expression correlated with shorter OS. UVA of clinical features identified low Karnofsky performance score (KPS), elevated serum lactate dehydrogenase (LDH), presence of extracranial metastases (ECMs), and uncontrolled (versus controlled) ECMs as clinical predictors of shorter survival. Multivariate analyses (MVA) were performed with significant clinical factors and all immune features without any redundant highly correlated variables in the model. After backward selection, multivariable coxPH model identified low KPS, low T cell signature, and low monocytic lineage signature as independent predictors of shorter survival. Finally, comparative analysis of MBMs from patients with MBMs only showed that these tumors were characterized by decreased oxidative phosphorylation (OXPHOS) and increased immune infiltration signature versus MBMs from patients with concurrent ECMs. Together these results support the clinical significance of specific immune features of MBMs and suggest their potential use as prognostic biomarkers.

脑转移的黑色素瘤患者总体生存的分子和临床特征的综合分析。
高达60%的转移性黑色素瘤患者被诊断为脑转移瘤(MBMs)。先前的研究已经确定了与MBM诊断后总生存率(OS)相关的临床因素。然而,与OS相关的分子和免疫特征尚不清楚。对骨髓瘤的分子和免疫相关因素的进一步了解可以为MBM患者的预后提供见解,并指导治疗开发。因此,我们分析了1991年至2015年间在我们机构接受手术切除(通过开颅)的74名黑色素瘤患者的临床特征和结果,并从他们的MBMs中获得RNA-seq数据。中位术后OS为8.6个月(范围0.6-146.9)。在单变量分析(UVA)中,多个免疫基因特征的表达与OS的改善有关,包括IFN-γ指数、T细胞炎症和扩展免疫基因。几种免疫细胞类型(如T细胞、CD8 T细胞、细胞毒性淋巴细胞、NK细胞、单核细胞)的基因表达特征与OS呈正相关,而中性粒细胞基因表达越高,OS越短。临床特征的UVA确定低Karnofsky表现评分(KPS),血清乳酸脱氢酶(LDH)升高,颅外转移(ecm)的存在以及未控制(对照)ecm作为较短生存期的临床预测因子。多变量分析(MVA)包括显著的临床因素和所有免疫特征,模型中没有任何冗余的高度相关变量。在逆向选择后,多变量coxPH模型确定低KPS、低T细胞特征和低单核细胞谱系特征是较短生存期的独立预测因素。最后,与合并ecm患者的MBMs相比,来自MBMs患者的MBMs的比较分析仅显示,这些肿瘤的特征是氧化磷酸化(OXPHOS)降低,免疫浸润特征增加。总之,这些结果支持MBMs特异性免疫特征的临床意义,并建议它们作为预后生物标志物的潜在用途。
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来源期刊
Acta Neuropathologica Communications
Acta Neuropathologica Communications Medicine-Pathology and Forensic Medicine
CiteScore
11.20
自引率
2.80%
发文量
162
审稿时长
8 weeks
期刊介绍: "Acta Neuropathologica Communications (ANC)" is a peer-reviewed journal that specializes in the rapid publication of research articles focused on the mechanisms underlying neurological diseases. The journal emphasizes the use of molecular, cellular, and morphological techniques applied to experimental or human tissues to investigate the pathogenesis of neurological disorders. ANC is committed to a fast-track publication process, aiming to publish accepted manuscripts within two months of submission. This expedited timeline is designed to ensure that the latest findings in neuroscience and pathology are disseminated quickly to the scientific community, fostering rapid advancements in the field of neurology and neuroscience. The journal's focus on cutting-edge research and its swift publication schedule make it a valuable resource for researchers, clinicians, and other professionals interested in the study and treatment of neurological conditions.
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