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      A novel anoikis-related gene signature to predict the prognosis, immune infiltration, and therapeutic outcome of lung adenocarcinoma

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          Abstract

          Background

          Lung cancer is a highly aggressive disease and the leading cause of cancer-related deaths. Lung adenocarcinoma (LUAD) is the most common histological subtype of lung cancer. As a type of programmed cell death, anoikis serves a key role in tumor metastasis. However, as few studies have focused on anoikis and prognostic indicators in LUAD, in this study, we constructed an anoikis-related risk model to explore how anoikis could influence the tumor microenvironment (TME), clinical treatment, and prognosis in LUAD patients; we aimed to provide new insight for future research.

          Methods

          Using patient data from Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA), we utilized the ‘limma’ package to select differentially expressed genes (DEGs) associated with anoikis and then they were divided into 2 clusters with consensus clustering. Risk models were constructed with least absolute shrinkage and selection operator (LASSO) Cox regression (LCR). Kaplan-Meier (KM) analysis and receiver operating characteristic (ROC) curves were performed to assess the independent risk factors for different clinical characteristics, including age, sex, disease stage, grade, and their associated risk scores. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) were performed to explore the biological pathways in our model. The effectiveness of clinical treatment was detected according to tumor immune dysfunction and exclusion (TIDE), The Cancer Immunome Atlas (TCIA), and IMvigor210.

          Results

          Our model was found to divide LUAD patients into high- and low-risk groups well, in which high risk groups had poor overall survival (OS), indicating that risk score could be an independent risk factor to predict the prognosis of LUAD patients. Interestingly, we found that anoikis could not only influence the extracellular organization but also play great roles in immune infiltration and immunotherapy, which might provide a new insight for future research.

          Conclusions

          The risk model constructed in this study can benefit to predict patient survival. Our results provided new potential treatment strategies.

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          Most cited references40

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            TGF-β attenuates tumour response to PD-L1 blockade by contributing to exclusion of T cells

            Therapeutic antibodies that block the programmed death-ligand 1 (PD-L1)/programmed death-1 (PD-1) pathway can induce robust and durable responses in patients with various cancers, including metastatic urothelial cancer (mUC) 1–5 . However, these responses only occur in a subset of patients. Elucidating the determinants of response and resistance is key to improving outcomes and developing new treatment strategies. Here, we examined tumours from a large cohort of mUC patients treated with an anti–PD-L1 agent (atezolizumab) and identified major determinants of clinical outcome. Response was associated with CD8+ T-effector cell phenotype and, to an even greater extent, high neoantigen or tumour mutation burden (TMB). Lack of response was associated with a signature of transforming growth factor β (TGF-β) signalling in fibroblasts, particularly in patients with CD8+ T cells that were excluded from the tumour parenchyma and instead found in the fibroblast- and collagen-rich peritumoural stroma—a common phenotype among patients with mUC. Using a mouse model that recapitulates this immune excluded phenotype, we found that therapeutic administration of a TGF-β blocking antibody together with anti–PD-L1 reduced TGF-β signalling in stromal cells, facilitated T cell penetration into the centre of the tumour, and provoked vigorous anti-tumour immunity and tumour regression. Integration of these three independent biological features provides the best basis for understanding outcome in this setting and suggests that TGF-β shapes the tumour microenvironment to restrain anti-tumour immunity by restricting T cell infiltration.
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              Tumor metastasis: molecular insights and evolving paradigms.

              Metastases represent the end products of a multistep cell-biological process termed the invasion-metastasis cascade, which involves dissemination of cancer cells to anatomically distant organ sites and their subsequent adaptation to foreign tissue microenvironments. Each of these events is driven by the acquisition of genetic and/or epigenetic alterations within tumor cells and the co-option of nonneoplastic stromal cells, which together endow incipient metastatic cells with traits needed to generate macroscopic metastases. Recent advances provide provocative insights into these cell-biological and molecular changes, which have implications regarding the steps of the invasion-metastasis cascade that appear amenable to therapeutic targeting. Copyright © 2011 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                J Thorac Dis
                J Thorac Dis
                JTD
                Journal of Thoracic Disease
                AME Publishing Company
                2072-1439
                2077-6624
                31 March 2023
                31 March 2023
                31 March 2023
                : 15
                : 3
                : 1335-1352
                Affiliations
                [1 ]deptDepartment of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College , Huazhong University of Science and Technology , Wuhan, China;
                [2 ]deptKey Laboratory of Pulmonary Diseases of Ministry of Health, School of Basic Medicine, Tongji Medical College , Huazhong University of Science and Technology , Wuhan, China
                Author notes

                Contributions: (I) Conception and design: Y Wang, Y Su; (II) Administrative support: Y Su; (III) Provision of study materials or patients: Y Wang; (IV) Collection and assembly of data: Y Wang; (V) Data analysis and interpretation: Y Wang, C Xie; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                Correspondence to: Yuan Su. Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Key Laboratory of Pulmonary Diseases of Ministry of Health, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. Email: suyuan319@ 123456sina.com .
                Article
                jtd-15-03-1335
                10.21037/jtd-23-149
                10089838
                c0766c62-d8f0-4886-8041-ff2ac51e5730
                2023 Journal of Thoracic Disease. All rights reserved.

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                : 11 January 2023
                : 21 March 2023
                Categories
                Original Article

                lung adenocarcinoma (luad),anoikis,immunotherapy,prognostic indicators,histological subtype

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