Abstract

BRAF mutated colon cancer presents with poor survival, and the treatment strategies are controversial. The tumor microenvironment, which plays a key role in tumorigenesis as well as responses to treatments, of this subtype is largely unknown. In the present study, we analyzed the differences of immune microenvironments between BRAF mutated and BRAF wild-type colon cancer utilizing datasets from The Cancer Genome Atlas and Gene Expression Omnibus and confirmed the findings by tissue specimens of patients. We found that BRAF mutated colon cancer had more stromal cells, more immune cell infiltration, and lower tumor purity. Many immunotherapeutic targets, including PD-1, PD-L1, CTLA-4, LAG-3, and TIM-3, were highly expressed in BRAF mutated patients. BRAF mutation was also correlated with higher proportions of neutrophils and macrophages M1, and lower proportions of plasma cells, dendritic cells resting, and T cells CD4 naïve. In conclusion, our study demonstrates a different pattern of the immune microenvironment in BRAF mutated colon cancer and provides insights into the future use of checkpoint inhibitors in this subgroup of patients.

Highlights

  • IntroductionColon cancer accounts for 6.0% of new cancer cases, with more than a million new cases of colon cancer identified in year 2020, and 5.8% of cancer deaths (Sung et al, 2021)

  • Colon cancer is one of the leading causes of cancer-related deaths worldwide

  • Similar results were found in patients from the Gene Expression Omnibus (GEO) cohort; BRAF mutated patients were more likely to be female (p = 0.0018), older (p < 0.0001), and had the tumor at the right colon (p < 0.0001)

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Summary

Introduction

Colon cancer accounts for 6.0% of new cancer cases, with more than a million new cases of colon cancer identified in year 2020, and 5.8% of cancer deaths (Sung et al, 2021). Both environmental and genetic factors, such as mutated genes, inflammation, radiation, and hereditary disorders, contribute to tumorigenesis of colon cancer (Chan and Giovannucci, 2010). The BRAF mutation accounts for around 10% cases of colon cancer and serves as a strong negative prognostic marker for patients (Davies et al, 2002; Gonsalves et al, 2014; Barras et al, 2017). BRAF mutated colon cancer often derives from sessile serrated adenoma and tends to be high grade, poorly differentiated, and located on right-sided colon, and has more mucinous component, more peritoneal and lymph node metastases, but less lung metastases (Matos and Jordan, 2018; Lee et al, 2019)

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