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Genomic and Transcriptomic Determinants of Therapy Resistance and Immune Landscape Evolution during Anti-EGFR Treatment in Colorectal Cancer

Authors: Woolston, A; Khan, K; Spain, G; Barber, LJ; Griffiths, B; Gonzalez-Exposito, R; Hornsteiner, L; +32 Authors
APC: 5,538.84 EUR

Genomic and Transcriptomic Determinants of Therapy Resistance and Immune Landscape Evolution during Anti-EGFR Treatment in Colorectal Cancer

Abstract

Despite biomarker stratification, the anti-EGFR antibody cetuximab is only effective against a subgroup of colorectal cancers (CRCs). This genomic and transcriptomic analysis of the cetuximab resistance landscape in 35 RAS wild-type CRCs identified associations of NF1 and non-canonical RAS/RAF aberrations with primary resistance and validated transcriptomic CRC subtypes as non-genetic predictors of benefit. Sixty-four percent of biopsies with acquired resistance harbored no genetic resistance drivers. Most of these had switched from a cetuximab-sensitive transcriptomic subtype at baseline to a fibroblast- and growth factor-rich subtype at progression. Fibroblast-supernatant conferred cetuximab resistance in vitro, confirming a major role for non-genetic resistance through stromal remodeling. Cetuximab treatment increased cytotoxic immune infiltrates and PD-L1 and LAG3 immune checkpoint expression, potentially providing opportunities to treat cetuximab-resistant CRCs with immunotherapy.

Country
United Kingdom
Keywords

570, EGFR, Biopsy, DNA Mutational Analysis, Drug Resistance, 610, Cetuximab, Antineoplastic Agents, colorectal cancer, Kaplan-Meier Estimate, Article, Cancer evolution, Molecular subtype, Antineoplastic Agents, Immunological, cetuximab, Cancer genomics, Biomarkers, Tumor, Humans, Molecular Targeted Therapy, predictive biomarker, Cancer-associated fibroblasts, Neoplastic, cancer genomics, Tumor, cancer evolution, Drug resistance mechanisms, Gene Expression Profiling, Immunity, Computational Biology, molecular subtype, Prognosis, Colorectal cancer, ErbB Receptors, Gene Expression Regulation, Neoplastic, Predictive biomarker, Immunological, Treatment Outcome, Gene Expression Regulation, drug resistance mechanisms, Drug Resistance, Neoplasm, Mutation, Neoplasm, immunotherapy, Immunotherapy, Colorectal Neoplasms, Transcriptome, cancer-associated fibroblasts, Biomarkers

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
views
OpenAIRE UsageCountsViews provided by UsageCounts
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232
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38
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