Abstract

BackgroundImmune checkpoint inhibitors have achieved breakthrough efficacy in treating lung adenocarcinoma (LUAD) with wild-type epidermal growth factor receptor (EGFR), leading to the revision of the treatment guidelines. However, most patients with EGFR mutation are resistant to immunotherapy. It is particularly important to study the differences in tumor microenvironment (TME) between patients with and without EGFR mutation. However, relevant research has not been reported. Our previous study showed that secreted phosphoprotein 1 (SPP1) promotes macrophage M2 polarization and PD-L1 expression in LUAD, which may influence response to immunotherapy. Here, we assessed the role of SPP1 in different populations and its effects on the TME.MethodsWe compared the expression of SPP1 in LUAD tumor and normal tissues, and in samples with wild-type and mutant EGFR. We also evaluated the influence of SPP1 on survival. The LUAD data sets were downloaded from TCGA and CPTAC databases. Clinicopathologic characteristics associated with overall survival in TCGA were assessed using Cox regression analysis. GSEA revealed that several fundamental signaling pathways were enriched in the high SPP1 expression group. We applied CIBERSORT and xCell to calculate the proportion and abundance of tumor-infiltrating immune cells (TICs) in LUAD, and compared the differences in patients with high or low SPP1 expression and wild-type or mutant EGFR. In addition, we explored the correlation between SPP1 and CD276 for different groups.ResultsSPP1 expression was higher in LUAD tumor tissues and in people with EGFR mutation. High SPP1 expression was associated with poor prognosis. Univariate and multivariate cox analysis revealed that up-regulated SPP1 expression was independent indicator of poor prognosis. GSEA showed that the SPP1 high expression group was mainly enriched in immunosuppressed pathways. In the SPP1 high expression group, the infiltration of CD8+ T cells was lower and M2-type macrophages was higher. These results were also observed in patients with EGFR mutation. Furthermore, we found that the SPP1 expression was positively correlated with CD276, especially in patients with EGFR mutation.ConclusionSPP1 levels might be a useful marker of immunosuppression in patients with EGFR mutation, and could offer insight for therapeutics.

Highlights

  • Lung cancer has become one of the most serious threats to human health, and its global morbidity and mortality rank first among all cancer types [1]

  • Subgroup analysis of TCGA lung adenocarcinoma (LUAD) showed that patients with epidermal growth factor receptor (EGFR) mutation in secreted phosphoprotein 1 (SPP1) high-expression group had a poor prognosis (Supplementary Figure 1A; HR: 1.62 95% CI 0.90-2.93; P = 0.055)

  • EGFR mutation is a predictor of the therapeutic effects of EGFR-TKIs in patients with LUAD [2, 3]

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Summary

Introduction

Lung cancer has become one of the most serious threats to human health, and its global morbidity and mortality rank first among all cancer types [1]. In China, 50%–60% of patients with LUAD have epidermal growth factor receptor (EGFR) mutation. Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) targeted therapy has been recommended for treating patients with EGFR sensitive mutations and such therapy has significantly improved survival in advanced NSCLC [2, 3]. Immune checkpoint inhibitors (ICIs), represented by programmed cell death-1 (PD-1) and programmed cell deathligand 1(PD-L1) monoclonal antibodies, have presented a new approach for NSCLC treatment [5, 6]. ICIs achieve long-term disease control in patients who have developed an anti-tumor response, by activating the body’s immune system for tumor cell recognition and removal [7]. Immune checkpoint inhibitors have achieved breakthrough efficacy in treating lung adenocarcinoma (LUAD) with wild-type epidermal growth factor receptor (EGFR), leading to the revision of the treatment guidelines. We assessed the role of SPP1 in different populations and its effects on the TME

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