Abstract

The presence of actinic keratoses (AKs) increases a patient’s risk of developing squamous cell carcinoma by greater than six-fold. We evaluated the effect of topical treatment with imiquimod on the tumor microenvironment by measuring transcriptomic differences in AKs before and after treatment with imiquimod 3.75%. Biopsies were collected prospectively from 21 patients and examined histologically. RNA was extracted and transcriptomic analyses of 788 genes were performed using the nanoString assay. Imiquimod decreased number of AKs by study endpoint at week 14 (p < 0.0001). Post-imiquimod therapy, levels of CDK1, CXCL13, IL1B, GADPH, TTK, ILF3, EWSR1, BIRC5, PLAUR, ISG20, and C1QBP were significantly lower (adjusted p < 0.05). Complete responders (CR) exhibited a distinct pattern of inflammatory gene expression pre-treatment relative to incomplete responders (IR), with alterations in 15 inflammatory pathways (p < 0.05) reflecting differential expression of 103 genes (p < 0.05). Presence of adverse effects was associated with improved treatment response. Differences in gene expression were found between pre-treatment samples in CR versus IR, suggesting that higher levels of inflammation pre-treament may play a part in regression of AKs. Further characterization of the immune micro-environment in AKs may help develop biomarkers predictive of response to topical immune modulators and may guide therapy.

Details

Title
Transcriptomic analysis identifies differences in gene expression in actinic keratoses after treatment with imiquimod and between responders and non responders
Author
Trager, Megan H 1 ; Rizk Emanuelle 2 ; Rose, Sharon 3 ; Zhu Kuixi 4 ; Lau, Branden 4 ; Fullerton, Benjamin T 2 ; Pradhan Jaya 5 ; Moore, Michael 6 ; Srivastava, Ayush C 2 ; Singer, Giselle 3 ; Gartrell, Robyn 7 ; Chang, Rui 4 ; Geskin, Larisa J 1 ; Saenger, Yvonne M 8 ; Goldenberg, Gary 3 

 Columbia University Irving Medical Center, Department of Dermatology, New York, USA (GRID:grid.21729.3f) (ISNI:0000000419368729) 
 Columbia University Irving Medical Center, Department of Medicine, Division of Hematology/Oncology, New York, USA (GRID:grid.21729.3f) (ISNI:0000000419368729) 
 Mount Sinai Hospital, Department of Dermatology, New York, USA (GRID:grid.416167.3) 
 University of Arizona Health Sciences, Department of Neurology, Tucson, USA (GRID:grid.134563.6) (ISNI:0000 0001 2168 186X) 
 Columbia University Irving Medical Center, Department of Pathology, New York, USA (GRID:grid.21729.3f) (ISNI:0000000419368729) 
 Columbia University Irving Medical Center, Department of Surgery, New York, USA (GRID:grid.21729.3f) (ISNI:0000000419368729) 
 Columbia University Irving Medical Center, Department of Pediatrics, Division of Hematology/Oncology, New York, USA (GRID:grid.21729.3f) (ISNI:0000000419368729) 
 Columbia University Irving Medical Center, Department of Medicine, Division of Hematology/Oncology, New York, USA (GRID:grid.21729.3f) (ISNI:0000000419368729); Herbert Irving Pavilion, New York, USA (GRID:grid.21729.3f) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2516597228
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.