Abstract

Immune checkpoint inhibitors (ICIs) have made breakthrough progress in the treatment of various malignant tumors. However, only some patients receiving ICIs obtain long-lasting clinical effects, and some patients still do not achieve remission. Improving the treatment benefits of this part of the population has become a concern of clinicians. IL-1 signaling plays an important role in the tumor microenvironment (TME). However, the relationship between the IL-1 signaling mutation status and the prognosis of colon adenocarcinoma (COAD) patients receiving ICIs has not been reported. We downloaded the data of a COAD cohort receiving ICIs, including prognostic data and mutation data. Additionally, we downloaded the data of a COAD cohort from The Cancer Genome Atlas (TCGA) database, including clinical data, expression data and mutation data. Gene set enrichment analysis (GSEA) was used to assess differences in the activity of some key physiological pathways between the IL-1 signaling mutated-type (IL-1-MT) and IL-1 signaling wild-type (IL-1-WT) groups. The CIBERSORT algorithm was used to evaluate the contents of immune cells in the TME of COAD patients. The multivariate Cox regression model results suggested that IL-1-MT can be used as an independent predictor of a better prognosis in COAD patients receiving ICIs (P = 0.03, HR = 0.269, 95% CI: 0.082-0.883). Additionally, IL-1-MT COAD patients had significantly longer overall survival (OS) (log-rank P = 0.015). CIBERSORT analysis showed that the IL-1-MT group had high infiltration levels of activated dendritic cells (DCs), M1 macrophages, neutrophils, activated natural killer (NK) cells, activated CD4+ memory T cells and CD8+ T cells. Similarly, the IL-1-MT group had significantly upregulated immunogenicity, including in terms of the tumor mutation burden (TMB), neoantigen load (NAL) and number of mutations in DNA damage repair (DDR) signaling. GSEA showed that the IL-1-MT group was highly enriched in the immune response and proinflammatory mediators. Additionally, the expression levels of immune-related genes, immune checkpoint molecules and immune-related signatures were significantly higher in the IL-1-MT group than in the IL-1-WT group. IL-1-MT may be an independent predictor of a good prognosis in COAD patients receiving ICIs, with significantly longer OS in IL-1-MT COAD patients. Additionally, IL-1-MT was associated with significantly increased immunogenicity, activated immune cell and inflammatory mediator levels and immune response-related scores.

Highlights

  • Immune checkpoint inhibitors (ICIs) have made breakthrough progress in the treatment of various malignant tumors [1,2,3]

  • We found that age and sample type were not significantly associated with the immunotherapy prognosis (P > 0.05), while IL-1-MT colon adenocarcinoma (COAD) patients treated with immunotherapy were associated with better prognosis (P = 0.024, hazard ratio (HR) = 0.255, 95% confidence interval (CI): 0.078-0.834; Figure 1A)

  • The results showed that only IL-1-MT could be used as an independent predictor of good prognosis in COAD patients receiving ICIs (P = 0.03, homologous recombination (HR) = 0.269, 95% CI: 0.082-0.883; Figure 1A)

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Summary

Introduction

Immune checkpoint inhibitors (ICIs) have made breakthrough progress in the treatment of various malignant tumors [1,2,3]. Recent studies have shown that colorectal cancer (CRC) patients who benefit from ICIs are mainly those with high mutation burden and mismatch repair deficiency (dMMR), and this population accounts for only approximately 5% of metastatic CRC [4]. Various potential biomarkers have been found in colon adenocarcinoma (COAD) patients receiving immunotherapy, such as microsatellite instability (MSI), programmed cell death-ligand 1 (PD-L1) expression, tumor mutation burden (TMB) and BRAF and KRAS gene mutation status [6]. The dMMR/microsatellite instability high (MSI-H) COAD population is considered to derive the most benefits from ICI treatment, but the effective rate is only 30%-40% [7], and this subset only accounts for a small part of the COAD population. Finding new markers to predict the efficacy of ICIs in COAD patients has become an important challenge

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