Abstract

Although surgery for early-stage lung cancer offers the best chance of cure, recurrence still occurs between 30 and 50% of the time. Why patients frequently recur after complete resection of early-stage lung cancer remains unclear. Using a large cohort of stage I lung adenocarcinoma patients, distinct genetic, genomic, epigenetic, and immunologic profiles of recurrent tumors were analyzed using a novel recurrence classifier. To characterize the tumor immune microenvironment of recurrent stage I tumors, unique tumor-infiltrating immune population markers were identified using single cell RNA-seq on a separate cohort of patients undergoing stage I lung adenocarcinoma resection and applied to a large study cohort using digital cytometry. Recurrent stage I lung adenocarcinomas demonstrated higher mutation and lower methylation burden than non-recurrent tumors, as well as widespread activation of known cancer and cell cycle pathways. Simultaneously, recurrent tumors displayed downregulation of immune response pathways including antigen presentation and Th1/Th2 activation. Recurrent tumors were depleted in adaptive immune populations, and depletion of adaptive immune populations and low cytolytic activity were prognostic of stage I recurrence. Genomic instability and impaired adaptive immune responses are key features of stage I lung adenocarcinoma immunosurveillance escape and recurrence after surgery.

Details

Title
Genetic and immunologic features of recurrent stage I lung adenocarcinoma
Author
Kratz, Johannes R 1 ; Li, Jack Z 2 ; Tsui, Jessica 3 ; Lee, Jen C 2 ; Ding, Vivianne W 2 ; Rao, Arjun A 3 ; Mann, Michael J 2 ; Chan, Vincent 4 ; Combes, Alexis J 3 ; Krummel, Matthew F 5 ; Jablons, David M 2 

 University of California San Francisco, Department of Surgery, Division of Cardiothoracic Surgery, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, Thoracic Oncology Laboratory, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, ImmunoX Initiative, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811) 
 University of California San Francisco, Department of Surgery, Division of Cardiothoracic Surgery, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, Thoracic Oncology Laboratory, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811) 
 University of California San Francisco, ImmunoX Initiative, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, Department of Pathology, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, UCSF CoLabs, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811) 
 University of California San Francisco, ImmunoX Initiative, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, Department of Pathology, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, UCSF CoLabs, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, Department of Microbiology and Immunology, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811) 
 University of California San Francisco, ImmunoX Initiative, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811); University of California San Francisco, Department of Pathology, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2607919643
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.