Abstract

BackgroundAlthough the tumour immune microenvironment is known to significantly influence immunotherapy outcomes, its association with changes in gene expression patterns in hepatocellular carcinoma (HCC) during immunotherapy and its effect on prognosis have not been clarified.MethodsA total of 365 HCC samples from The Cancer Genome Atlas liver hepatocellular carcinoma (TCGA-LIHC) dataset were stratified into training datasets and verification datasets. In the training datasets, immune-related genes were analysed through univariate Cox regression analyses and least absolute shrinkage and selection operator (LASSO)-Cox analyses to build a prognostic model. The TCGA-LIHC, GSE14520, and Imvigor210 cohorts were subjected to time-dependent receiver operating characteristic (ROC) and Kaplan–Meier survival curve analyses to verify the reliability of the developed model. Finally, single-sample gene set enrichment analysis (ssGSEA) was used to study the underlying molecular mechanisms.ResultsFive immune-related genes (LDHA, PPAT, BFSP1, NR0B1, and PFKFB4) were identified and used to establish the prognostic model for patient response to HCC treatment. ROC curve analysis of the TCGA (training and validation sets) and GSE14520 cohorts confirmed the predictive ability of the five-gene-based model (AUC > 0.6). In addition, ROC and Kaplan–Meier analyses indicated that the model could stratify patients into a low-risk and a high-risk group, wherein the high-risk group exhibited worse prognosis and was less sensitive to immunotherapy than the low-risk group. Functional enrichment analysis predicted potential associations of the five genes with several metabolic processes and oncological signatures.ConclusionsWe established a novel five-gene-based prognostic model based on the tumour immune microenvironment that can predict immunotherapy efficacy in HCC patients.

Highlights

  • The tumour immune microenvironment is known to significantly influence immunotherapy outcomes, its association with changes in gene expression patterns in hepatocellular carcinoma (HCC) during immunotherapy and its effect on prognosis have not been clarified

  • The results indicate that our model can effectively predict the efficacy of immunotherapy and that the five genes can serve as potential independent biomarkers in clinical applications

  • The risk score was calculated by summing the weighted gene expression level of each of the five genes multiplied by their respective least absolute shrinkage and selection operator (LASSO) coefficients: risk score = [0.307 × mRNA expression level of lactate dehydrogenase A (LDHA)] + [0.268 × mRNA expression level of pyrophosphate amidotransferase (PPAT)] + [0.455 × mRNA expression level of beaded filament structural protein 1 (BFSP1)] + [0.234 × mRNA expression level of NR0B1] + [0.109 × mRNA expression level of PFKFB4]

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Summary

Introduction

The tumour immune microenvironment is known to significantly influence immunotherapy outcomes, its association with changes in gene expression patterns in hepatocellular carcinoma (HCC) during immunotherapy and its effect on prognosis have not been clarified. It is important to elucidate the molecular mechanisms underlying HCC progression and develop novel therapeutic targets to improve patient survival outcomes. The immune microenvironment plays a critical role in tumorigenesis and is correlated with tumour progression and treatment efficacy [3, 4]. Systemic immune therapeutics have shown efficacy against HCC, especially for patients without an opportunity to undergo resection or liver transplantation [2, 5]. Common immunotherapy strategies include chimeric antigen receptor-engineered T cells (CAR-T cells), cancer vaccines, cytokine therapy, and immune checkpoint inhibitors (ICIs). Only approximately 25% of HCC patients with high infiltration of PD-1-expressing T cells respond to ICIs [9], and identification of patients who will respond well to ICIs is challenging

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