期刊
CLINICAL CANCER RESEARCH
卷 27, 期 11, 页码 3215-3223出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1078-0432.CCR-20-4261
关键词
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类别
资金
- Wellcome Intermediate Fellowship [110078/Z/15/Z]
- Cancer Research UK [A27412]
- Leo Pharma Foundation
- Royal Society [RGS\R1\201222]
- European Commission [FP7-PEOPLE-2013-IEF -6270270]
- NIHR Biomedical Research Centre, Manchester, United Kingdom
- Royal College of Surgeons in Ireland StAR programme
- Wellcome Trust [110078/Z/15/Z] Funding Source: Wellcome Trust
This study demonstrates that cSCC is more aggressive in men, while immunocompetent women develop mild cSCC later in life. The research also shows that female immunity offers greater protection than male immunity against cSCC.
Purpose: Cancer susceptibility and mortality are higher in males, and the mutational and transcriptomic landscape of cancer differs by sex. The current assumption is that men are at higher risk of epithelial cancers as they expose more to carcinogens and accumulate more damage than women. We present data showing women present with less aggressive primary cutaneous squamous cell carcinoma (cSCC) and early strong immune activation. Experimental Design: We explored clinical and molecular sexual disparity in immunocompetent and immunosuppressed patients with primary cSCC (N = 738, N = 160), advanced-stage cSCC (N = 63, N = 20) and FVB/N mice exposed to equal doses of DMBA, as well as in human keratinocytes by whole-exome, bulk, and single-cell RNA sequencing. Results: We show cSCC is more aggressive in men, and immunocompetent women develop mild cSCC, later in life. To test whether sex drives disparity, we exposed male and female mice to equal doses of carcinogen, and found males present with more aggressive, metastatic cSCC than females. Critically, females activate cancer immune-related expression pathways and CD4 and CD8 T-cell infiltration independently of mutations, a response that is absent in prednisolone-treated animals. In contrast, males increase the rate of mitosis and proliferation in response to carcinogen. Women's skin and keratinocytes also activate immune-cancer fighting pathways and immune cells at UV radiation-damaged sites. Critically, a compromised immune system leads to high-risk, aggressive cSCC specifically in women. Conclusions: This work shows the immune response is sex biased in cSCC and highlights female immunity offers greater protection than male immunity.
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