Pharmacogenomics-based subtype decoded implications for risk stratification and immunotherapy in pancreatic adenocarcinoma.

IF 6.4 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Molecular Medicine Pub Date : 2025-02-19 DOI:10.1186/s10020-024-01049-6
Xing Zhou, Yuhao Ba, Nuo Xu, Hui Xu, Yuyuan Zhang, Long Liu, Siyuan Weng, Shutong Liu, Zhe Xing, Shuang Chen, Peng Luo, Libo Wang, Xinwei Han
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Abstract

Background: With fatal malignant peculiarities and poor survival rate, outcomes of pancreatic adenocarcinoma (PAAD) were frustrated by non-response and even resistance to therapy due to heterogeneity across clinical patients. Nevertheless, pharmacogenomics has been developed for individualized-treatment and still maintains obscure in PAAD.

Methods: A total of 964 samples from 10 independent multi-center cohorts were enrolled in our study. With drug response data from the profiling of relative inhibition simultaneously in mixtures (PRISM) and genomics of drug sensitivity in cancer (GDSC) databases, we established and validated multidimensionally three pharmacogenomics-classified subtypes using non-negative matrix factorization (NMF) and nearest template prediction (NTP) algorithms, separately. The heterogenous biological characteristics and precision medicine strategies among subtypes were further investigated.

Results: Three pharmacogenomics-classified subtypes after stable and reproducible validation, distinguished in six aspects of prognosis, biological peculiarities, immune landscapes, genomic variations, immunotherapy and individualized management strategies. Subtype 2 was close to immunocompetent phenotype and projected to immunotherapy; Subtype 3 held most favorable outcomes and metabolic pathways distinctively, promising to be treated with first-line agents. Subtype 1 with worst prognosis, was anticipated to chromosome instability (CIN) phenotype and resistant to chemotherapeutic agents. In addition, ITGB6 contributed to subtype 1 resistance to 5-fluorouracil, and knockdown of ITGB6 enhanced sensitivity to 5-fluorouracil in in vitro experiments. Ultimately, appropriate clinical stratified treatments were assigned to corresponding subtypes according to pharmacogenomic transcripts. Some limitations were not taken into account, thus needs to be supported by more research.

Conclusion: A span-new molecular subtype exploited for PAAD uncovered an insight into precise medication on ground of pharmacogenomics, and highly refined multiple clinical management strategies for specific patients.

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基于药物基因组学的亚型解码对胰腺腺癌风险分层和免疫治疗的影响。
背景:胰腺腺癌(PAAD)具有致命的恶性特征和较低的生存率,由于临床患者的异质性,其治疗无反应甚至耐药,结果令人沮丧。尽管如此,药物基因组学已经发展到个体化治疗,但在PAAD中仍处于模糊状态。方法:来自10个独立多中心队列的964个样本被纳入我们的研究。利用来自混合物相对抑制谱(PRISM)和癌症药物敏感性基因组学(GDSC)数据库的药物反应数据,我们分别使用非负矩阵分解(NMF)和最近模板预测(NTP)算法建立并验证了多维的三种药物基因组学分类亚型。进一步研究不同亚型间的异质性生物学特性和精准医疗策略。结果:经稳定性和可重复性验证的3种药物基因组学分类亚型,在预后、生物学特性、免疫景观、基因组变异、免疫治疗和个体化管理策略6个方面进行区分。亚型2接近免疫活性表型,并预测免疫治疗;亚型3具有最有利的结果和独特的代谢途径,有望用一线药物治疗。亚型1预后最差,预计为染色体不稳定(CIN)表型,对化疗药物耐药。此外,ITGB6参与了1亚型对5-氟尿嘧啶的耐药,在体外实验中,敲除ITGB6增强了对5-氟尿嘧啶的敏感性。最终,根据药物基因组转录本,将适当的临床分层治疗分配给相应的亚型。有些限制没有考虑到,因此需要更多的研究来支持。结论:利用PAAD的一个全新分子亚型,为基于药物基因组学的精准用药提供了新的思路,并为特定患者的多种临床管理策略提供了高度细化。
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来源期刊
Molecular Medicine
Molecular Medicine 医学-生化与分子生物学
CiteScore
8.60
自引率
0.00%
发文量
137
审稿时长
1 months
期刊介绍: Molecular Medicine is an open access journal that focuses on publishing recent findings related to disease pathogenesis at the molecular or physiological level. These insights can potentially contribute to the development of specific tools for disease diagnosis, treatment, or prevention. The journal considers manuscripts that present material pertinent to the genetic, molecular, or cellular underpinnings of critical physiological or disease processes. Submissions to Molecular Medicine are expected to elucidate the broader implications of the research findings for human disease and medicine in a manner that is accessible to a wide audience.
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