期刊
CLINICAL CANCER RESEARCH
卷 27, 期 2, 页码 566-574出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1078-0432.CCR-20-2371
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资金
- Prostate Cancer Foundation Young Investigator Award
- Prostate Cancer UK
- Movember Foundation through the London Movember Centre of Excellence [CEO13_2-002]
- US Department of Defense
- Prostate Cancer Foundation [20131017, 20131017-1]
- Stand Up To Cancer [SU2C-AACR-DT0712]
- Cancer Research UK [CRM108X-A25144, C12540 A12829, C12540/A13230, C12540/A20447, CRUK/11/029]
- UK Department of Health through an Experimental Cancer Medicine Centre [ECMC-CRM064X]
- Medical Research Council
- Academy of Medical Sciences
- AstraZeneca
- National Institute for Health Research Cancer Research Network
Patients with CDK12-altered mCRPC have a worse prognosis, and their tumors are primarily enriched for CD4(+)FOXP3(-) cells, which may be associated with poor outcomes and immunosuppression.
Purpose: Cyclin-dependent kinase 12 (CDK12) aberrations have been reported as a biomarker of response to immunotherapy for metastatic castration-resistant prostate cancer (mCRPC). Herein, we characterize CDK12-mutated mCRPC, presenting clinical, genomic, and tumor-infiltrating lymphocyte (TIL) data. Experimental Design: Patients with mCRPC consented to the molecular analyses of diagnostic and mCRPC biopsies. Genomic analyses involved targeted next-generation (MiSeq; Illumina) and exome sequencing (NovaSeq; Illumina). TILs were assessed by validated immunocytochemistry coupled with deep learning-based artificial intelligence analyses including multiplex immunofluorescence assays for CD4, CD8, and FOXP3 evaluating TIL subsets. The control group comprised a randomly selected mCRPC cohort with sequencing and clinical data available. Results: Biopsies from 913 patients underwent targeted sequencing between February 2015 and October 2019. Forty-three patients (4.7%) had tumors with CDK12 alterations. CDK12-altered cancers had distinctive features, with some revealing high chromosomal break numbers in exome sequencing. Biallelic CDK12-aberrant mCRPCs had shorter overall survival from diagnosis than controls [5.1 years (95% confidence interval (CI), 4.0-7.9) vs. 6.4 years (95% CI, 5.7-7.8); hazard ratio (HR), 1.65 (95% CI, 1.07-2.53); P = 0.02]. Median intratumoral CD3(+) cell density was higher in CDK12 cancers, although this was not statistically significant (203.7 vs. 86.7 cells/mm(2); P = 0.07). This infiltrate primarily comprised of CD4(+)FOXP3(-) cells (50.5 vs. 6.2 cells/mm(2); P < 0.0001), where high counts tended to be associated with worse survival from diagnosis (HR, 1.64; 95% CI, 0.95-2.84; P = 0.077) in the overall population. Conclusions: CDK12-altered mCRPCs have worse prognosis, with these tumors surprisingly being primarily enriched for CD4(+)FOXP3(-) cells that seem to associate with worse outcome and may be immunosuppressive.
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