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학술저널
저자정보
형재원 (서울아산병원) 조은정 (울산대학교) 김지훈 (서울아산병원 병리과) 김좌훈 (울산대학교) 김정은 (울산대학교) 홍용상 (서울아산병원) 김태원 (울산대학교) 성창옥 (울산대학교) 김선영 (서울아산병원)
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제54권 제4호
발행연도
2022.10
수록면
1,175 - 1,190 (16page)
DOI
10.4143/crt.2021.1133

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Purpose Recent clinical trials have reported response rates < 50% among patients treated with programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors for microsatellite instability‒high (MSI-H) colorectal cancer (CRC), and factors predicting treatment response have not been fully identified. This study aimed to identify potential biomarkers of PD-1/PD-L1 inhibitor treatment response among patients with MSI-H CRC. Materials and Methods MSI-H CRC patients enrolled in three clinical trials of PD-1/PD-L1 blockade at Asan Medical Center (Seoul, Republic of Korea) were screened and classified into two groups according to treatment response. Their histopathologic features and expression of 730 immune-related genes from the NanoString platform were evaluated, and a machine learning–based classification model was built to predict treatment response among MSI-H CRCs patients.Results A total of 27 patients (15 responders, 12 non-responders) were included. A high degree of lymphocytic/neutrophilic infiltration and an expansile tumor border were associated with treatment response and prolonged progression-free survival (PFS), while mucinous/signet-ring cell carcinoma was associated with a lack of treatment response and short PFS. Gene expression profiles revealed that the interferon-γ response pathway was enriched in the responder group. Of the top eight differentially expressed immune-related genes, <i>PRAME</i> had the highest fold change in the responder group. Higher expression of <i>PRAME</i> was independently associated with better PFS along with histologic subtypes in the multivariate analysis. The classification model using these genes showed good performance for predicting treatment response.Conclusion We identified histologic and immune-related gene expression characteristics associated with treatment response in MSI-H CRC, which may contribute to optimal patient stratification.

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