Abstract

Abstract Objective: To date, significant breakthrough has yet to be achieved in immunotherapy for HER2-positive breast cancer (HPBC). In this study, we aimed to construct a risk model for predicting prognosis and therapy response and evaluating the tumor immune landscape in HPBC patients. Methods: Differentially expressed immune-related genes (IRGs) were used as input to weighted correlation network analysis (WGCNA) to identify modules of highly correlated gene. An optimal prognostic TPBC-IRGs signature were constructed by least absolute shrinkage and selection operator (LASSO) cox regression. Survival analysis and ROC curves were analyzed to identify the predictive value in a training cohort and external validation cohorts. With three GEO datasets and samples from our center, the anti-HER2 therapeutic efficacy in HPBC patients was predicted through this prognostic model. Additionally, the immunotherapy outcome was forecasted using IMvigor210 dataset. We also investigated the connection between high and low-risk populations and immune checkpoints and analyzed immune infiltration levels of these populations with several algorithms. Ultimately, we develop a combined model and nomogram by integrating the risk score with clinical factors. Results: 11 key genes associated with overall survival (OS) in the blue module were selected for further analysis. A 3-gene signature (CX3CL1, RARB, TANK) based prognostic risk model was developed. The Kaplan-Meier survival curve revealed that patients with high-risk score had shorter OS compared with the low-risk group. The AUC of the training cohort at 1-, 3- and 5-year were 0.718, 0.784 and 0.767. The performance of the risk model was validated with GSE25066 and GSE55348. It’s showed that the risk scores of HPBC who were resistant to trastuzumab were significantly higher than those of patients who were sensitive to trastuzumab. The results indicated that the levels of immune checkpoints expression (such as PD-1, CTLA4 and TIGIT) and immune infiltration were higher in low-risk group than in high-risk group. The combined model showed better prognostic prediction accuracy compared to the clinical model or gene signature alone (1-year AUC=0.910;3-year AUC=0.832;5-year AUC=0.882). Conclusion: The immune gene-based risk profile and combined prognostic model in this study may hold promise for clinical use in predicting the prognosis and treatment efficacy of HPBC patients. figure3. Construction of HPBC-IRGs signature based prognostic model. Citation Format: Xiaofen Li, Wenfen Fu, Yushuai Yu, Jie Zhang, Chuangui Song. Clinical significance and immune landscape analyses of the immune related genes based prognostic signature for HER2 positive breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-24-10.

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