机构地区:[1]Department of General Surgery,Comprehensive Breast Health Center,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China [2]Shanghai Institute of Hematology,State Key Laboratory of Medical Genomics,National Research Center for Translational Medicine(Shanghai),Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China [3]Department of Hematology,Shanghai Institute of Hematology,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China [4]Department of Hematology,Shanghai Jiao Tong University Affiliated Sixth People’s Hospital,Shanghai,200025,China
出 处:《Frontiers of Medicine》2024年第2期357-374,共18页医学前沿(英文版)
基 金:supported by the National Natural Science Foundation of China(No.82130075 to Min Lu,No.82073292 to Min Lu,No.81772797 to Xiaosong Chen,No.82072937 to Xiaosong Chen,No.82072897 to Kunwei Shen,No.82002773 to Zheng Wang,No.81900157 to Ying Liang);SJTU Transmed Awards Research(to Min Lu),Shanghai Municipal Education Commission-Gaofeng Clinical Medicine(No.828318 to Min Lu and No.20172007 to Xiaosong Chen);Shanghai Excellent Youth Academic Leader(No.20XD1422700 to Min Lu);Program of Shanghai Science and Technology Committee(No.21S11900100 to Min Lu);Dawn Program of Shanghai Education Commission(No.21SG18 to Min Lu);Samuel Waxman Cancer Research Foundation(to Min Lu);Foundation of National Facility for Translational Medicine(Shanghai)(No.NRCTM(SH)-2021-08).
摘 要:p53 is mutated in half of cancer cases.However,no p53-targeting drugs have been approved.Here,we reposition decitabine for triple-negative breast cancer(TNBC),a subtype with frequent p53 mutations and extremely poor prognosis.In a retrospective study on tissue microarrays with 132 TNBC cases,DNMT1 overexpression was associated with p53 mutations(P=0.037)and poor overall survival(OS)(P=0.010).In a prospective DEciTabinE and Carboplatin in TNBC(DETECT)trial(NCT03295552),decitabine with carboplatin produced an objective response rate(ORR)of 42%in 12 patients with stage IV TNBC.Among the 9 trialed patients with available TP53 sequencing results,the 6 patients with p53 mutations had higher ORR(3/6 vs.0/3)and better OS(16.0 vs.4.0 months)than the patients with wild-type p53.In a mechanistic study,isogenic TNBC cell lines harboring DETECT-derived p53 mutations exhibited higher DNMT1 expression and decitabine sensitivity than the cell line with wild-type p53.In the DETECT trial,decitabine induced strong immune responses featuring the striking upregulation of the innate immune player IRF7 in the p53-mutated TNBC cell line(upregulation by 16-fold)and the most responsive patient with TNBC.Our integrative studies reveal the potential of repurposing decitabine for the treatment of p53-mutated TNBC and suggest IRF7 as a potential biomarker for decitabine-based treatments.
关 键 词:p53 mutation triple-negative breast cancer DECITABINE DNMT1 IRF7 innate immune response
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