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Pan-cancer analysis of NFE2L2 mutations identifies a subset of lung cancers with distinct genomic and improved immunotherapy outcomes
Wang, Kewei1; Li, Zixi1; Xuan, Ying2; Zhao, Yong3; Deng, Chao2; Wang, Meidan1; Xie, Chenjun1; Yuan, Fenglai1; Pang, Qingfeng2; Mao, Wenjun4; Cai, Dongyan5; Zhong, Zhangfeng6; Mei, Jie1,7
2023-12-01
Source PublicationCancer Cell International
ISSN1475-2867
Volume23Issue:1Pages:229
Abstract

Background: Mutations in the KEAP1-NFE2L2 signaling pathway were linked to increased tumorigenesis and aggressiveness. Interestingly, not all hotspot mutations on NFE2L2 were damaging; some even were activating. However, there was conflicting evidence about the association between NFE2L2 mutation and Nrf2-activating mutation and responsiveness to immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC) and other multiple cancers. Methods: The study with the largest sample size (n = 49,533) explored the landscape of NFE2L2 mutations and their impact response/resistance to ICIs using public cohorts. In addition, the in-house WXPH cohort was used to validate the efficacy of immunotherapy in the NFE2L2 mutated patients with NSCLC. Results: In two pan-cancer cohorts, Nrf2-activating mutation was associated with higher TMB value compared to wild-type. We identified a significant association between Nrf2-activating mutation and shorter overall survival in pan-cancer patients and NSCLC patients but not in those undergoing ICIs treatment. Similar findings were obtained in cancer patients carrying the NFE2L2 mutation. Furthermore, in NSCLC and other cancer cohorts, patients with NFE2L2 mutation demonstrated more objective responses to ICIs than patients with wild type. Our in-house WXPH cohort further confirmed the efficacy of immunotherapy in the NFE2L2 mutated patients with NSCLC. Lastly, decreased inflammatory signaling pathways and immune-depleted immunological microenvironments were enriched in Nrf2-activating mutation patients with NSCLC. Conclusions: Our study found that patients with Nrf2-activating mutation had improved immunotherapy outcomes than patients with wild type in NSCLC and other tumor cohorts, implying that Nrf2-activating mutation defined a distinct subset of pan-cancers and might have implications as a biomarker for guiding ICI treatment, especially NSCLC.

KeywordBiomarker Immunotherapy Nfe2l2 Ngs Nsclc
DOI10.1186/s12935-023-03056-9
URLView the original
Indexed BySCIE
Language英語English
WOS Research AreaOncology
WOS SubjectOncology
WOS IDWOS:001079636100001
PublisherBMCCAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
Scopus ID2-s2.0-85173736162
Fulltext Access
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Document TypeJournal article
CollectionInstitute of Chinese Medical Sciences
Corresponding AuthorCai, Dongyan; Zhong, Zhangfeng; Mei, Jie
Affiliation1.Institute of Integrated Traditional Chinese and Western Medicine, Affiliated Hospital of Jiangnan University, Wuxi, China
2.Department of Physiopathology, Wuxi School of Medicine, Jiangnan University, Wuxi, China
3.Department of Thoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
4.Department of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, No. 299 Qingyang Road, 214023, China
5.Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, 200 Huihe Road, 214122, China
6.Macao Centre for Research and Development in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, SAR, 999078, Macao
7.Department of Oncology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, No. 299 Qingyang Road, 214023, China
Corresponding Author AffilicationInstitute of Chinese Medical Sciences
Recommended Citation
GB/T 7714
Wang, Kewei,Li, Zixi,Xuan, Ying,et al. Pan-cancer analysis of NFE2L2 mutations identifies a subset of lung cancers with distinct genomic and improved immunotherapy outcomes[J]. Cancer Cell International, 2023, 23(1), 229.
APA Wang, Kewei., Li, Zixi., Xuan, Ying., Zhao, Yong., Deng, Chao., Wang, Meidan., Xie, Chenjun., Yuan, Fenglai., Pang, Qingfeng., Mao, Wenjun., Cai, Dongyan., Zhong, Zhangfeng., & Mei, Jie (2023). Pan-cancer analysis of NFE2L2 mutations identifies a subset of lung cancers with distinct genomic and improved immunotherapy outcomes. Cancer Cell International, 23(1), 229.
MLA Wang, Kewei,et al."Pan-cancer analysis of NFE2L2 mutations identifies a subset of lung cancers with distinct genomic and improved immunotherapy outcomes".Cancer Cell International 23.1(2023):229.
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