Clinical significance of heterogeneity in multifocal hepatocellular carcinoma: A multi-omics study
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摘要: 超过一半的肝细胞癌(HCC)患者在就诊时肝内已出现多发病灶,临床上针对多灶HCC的治疗手段十分有限且疗效不佳。多灶HCC中肿瘤的高度异质性是导致治疗失败的重要原因。越来越多的研究采用多组学测序,探索多灶HCC中不同病灶间的基因水平和转录水平的异质性,包括肿瘤克隆进化以及基因突变、拷贝数变异、结构变异、RNA表达、肿瘤免疫微环境特征等的异质性。肿瘤克隆进化导致的药物靶点分布以及免疫微环境的特征可精准预测多灶HCC患者对靶向药物和免疫治疗的疗效。因此,全面、准确地评估多灶HCC的多组学异质性对实施精准治疗至关重要。Abstract: More than half of patients with hepatocellular carcinoma( HCC) have multiple lesions in the liver at the time when they attend the hospital,and there are limited treatment methods with poor efficacy for multifocal HCC in clinical practice. The high degree of tumor heterogeneity in multifocal HCC is the leading cause of treatment failure. More and more studies use multi-omics sequencing to explore the heterogeneity between different lesions at the genetic and transcriptional levels,including tumor clonal evolution,gene mutations,copy number variations,structural variations,RNA expression,and tumor immune microenvironment. Drug target distribution shaped by clonal evolution and the characteristics of immune microenvironment can accurately predict the response to targeted drugs and immunotherapy in patients with multifocal HCC. Therefore,a comprehensive and accurate assessment of the heterogeneity of multifocal HCC based on a multi-omics study is of vital importance in the implementation of precise treatment.
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Key words:
- carcinoma,hepatocellular /
- gene /
- diagnosis /
- therapeutics
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[1] BRAY F,FERLAY J,SOERJOMATARAM I,et al. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2018,68(6):394-424. [2] CHEN W,ZHENG R,BAADE PD,et al. Cancer statistics in China,2015[J]. CA Cancer J Clin,2016,66(2):115-132. [3] KUDO M,IZUMI N,ICHIDA T,et al. Report of the 19th follow-up survey of primary liver cancer in Japan[J]. Hepatol Res,2016,46(5):372-390. [4] DONG LQ,PENG LH,MA LJ,et al. Heterogeneous immunogenomic features and distinct escape mechanisms in multifocal hepatocellular carcinoma[J]. J Hepatol,2020,72(5):896-908. [5] XIE DY,FAN HK,REN ZG,et al. Identifying clonal origin of multifocal hepatocellular carcinoma and its clinical implications[J]. Clin Transl Gastroenterol,2019,10(2):e00006. [6] RAMACCIATO G,MERCANTINI P,PETRUCCIANI N,et al.Does surgical resection have a role in the treatment of large or multinodular hepatocellular carcinoma?[J]. Am Surg,2010,76(11):1189-1197. [7] BRUIX J,REIG M,SHERMAN M. Evidence-based diagnosis,staging,and treatment of patients with hepatocellular carcinoma[J]. Gastroenterology,2016,150(4):835-853. [8] BRUIX J,TAKAYAMA T,MAZZAFERRO V,et al. Adjuvant sorafenib for hepatocellular carcinoma after resection or ablation(STORM):A phase 3,randomised,double-blind,placebo-controlled trial[J]. Lancet Oncol,2015,16(13):1344-1354. [9] WHITE R,NAIR RL,BRADLEY RH. Theorizing the benefits and costs of adaptive cultures for development[J]. Am Psychol,2018,73(6):727-739. [10] KUDO M,FINN RS,QIN S,et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma:A randomised phase 3 non-inferiority trial[J]. Lancet,2018,391(10126):1163-1173. [11] SPINZI G,PAGGI S. Sorafenib in advanced hepatocellular carcinoma[J]. N Engl J Med,2008,359(23):2497-2498;author reply 2498-2499. [12] CROCENZI TS,EL-KHOUEIRY AB,YAU TC,et al. Nivolumab(nivo)in sorafenib(sor)-naive and-experienced pts with advanced hepatocellular carcinoma(HCC):CheckMate040 study[J]. 2017,35(15 suppl):4013. [13] EL-KHOUEIRY AB,SANGRO B,YAU T,et al. Nivolumab in patients with advanced hepatocellular carcinoma(CheckMate040):an open-label,non-comparative,phase 1/2 dose escalation and expansion trial[J]. Lancet, 2017, 389(10088):2492-2502. [14] ZHU AX,FINN RS,EDELINE J,et al. Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib(KEYNOTE-224):A non-randomised,open-label phase 2 trial[J]. Lancet Oncol,2018,19(7):940-952. [15] KELLEY RK. Adjuvant sorafenib for liver cancer:Wrong stage,wrong dose[J]. Lancet Oncol,2015,16(13):1279-1281. [16] HUANG A,ZHAO X,YANG XR,et al. Circumventing intratumoral heterogeneity to identify potential therapeutic targets in hepatocellular carcinoma[J]. J Hepatol,2017,67(2):293-301. [17] LIN DC,MAYAKONDA A,DINH HQ,et al. Genomic and epigenomic heterogeneity of hepatocellular carcinoma[J]. Cancer Res,2017,77(9):2255-2265. [18] TORRECILLA S,SIA D,HARRINGTON AN,et al. Trunk mutational events present minimal intra-and inter-tumoral heterogeneity in hepatocellular carcinoma[J]. J Hepatol,2017,67(6):1222-1231. [19] FEO F,PASCALE RM. Multifocal hepatocellular carcinoma:Intrahepatic metastasis or multicentric carcinogenesis?[J].Ann Transl Med,2015,3(1):4. [20] GAO Q,WANG ZC,DUAN M,et al. Cell culture system for analysis of genetic heterogeneity within hepatocellular carcinomas and response to pharmacologic agents[J]. Gastroenterology,2017,152(1):232-242. e4. [21] FURUTA M,UENO M,FUJIMOTO A,et al. Whole genome sequencing discriminates hepatocellular carcinoma with intrahepatic metastasis from multi-centric tumors[J]. J Hepatol,2017,66(2):363-373. [22] ZHAI W,LIM TK,ZHANG T,et al. The spatial organization of intra-tumour heterogeneity and evolutionary trajectories of metastases in hepatocellular carcinoma[J]. Nat Commun,2017,8:4565. [23] XU LX,HE MH,DAI ZH,et al. Genomic and transcriptional heterogeneity of multifocal hepatocellular carcinoma[J]. Ann Oncol,2019,30(6):990-997. [24] HUANG M,HE M,GUO Y,et al. The influence of immune heterogeneity on the effectiveness of immune checkpoint inhibitors in multifocal hepatocellular carcinomas[J]. Clin Cancer Res,2020,26(18):4947-4957. [25] SIA D,JIAO Y,MARTINEZ-QUETGLAS I,et al. Identification of an immune-specific class of hepatocellular carcinoma,based on molecular features[J]. Gastroenterology,2017,153(3):812-826. [26] DUAN M,HAO J,CUI S,et al. Diverse modes of clonal evolution in HBV-related hepatocellular carcinoma revealed by single-cell genome sequencing[J]. Cell Res,2018,28(3):359-373. [27] BAFFY G. Decoding multifocal hepatocellular carcinoma:An opportune pursuit[J]. Hepatobiliary Surg Nutr,2015,4(3):206-210. [28] MORIMOTO O,NAGANO H,SAKON M,et al. Diagnosis of intrahepatic metastasis and multicentric carcinogenesis by microsatellite loss of heterozygosity in patients with multiple and recurrent hepatocellular carcinomas[J]. J Hepatol,2003,39(2):215-221. [29] YAMAMOTO T,KAJINO K,KUDO M,et al. Determination of the clonal origin of multiple human hepatocellular carcinomas by cloning and polymerase chain reaction of the integrated hepatitis B virus DNA[J]. Hepatology, 1999, 29(5):1446-1452. [30] KAWAI S,IMAZEKI F,YOKOSUKA O,et al. Clonality in hepatocellular carcinoma:Analysis of methylation pattern of polymorphic X-chromosome-linked phosphoglycerate kinase gene in females[J]. Hepatology,1995,22(1):112-117. [31] MIAO R,LUO H,ZHOU H,et al. Identification of prognostic biomarkers in hepatitis B virus-related hepatocellular carcinoma and stratification by integrative multi-omics analysis[J]. J Hepatol,2014,61(4):840-849. [32] ZHANG Q,LOU Y,YANG J,et al. Integrated multiomic analysis reveals comprehensive tumour heterogeneity and novel immunophenotypic classification in hepatocellular carcinomas[J]. Gut,2019,68(11):2019-2031. [33] XUE R,LI R,GUO H,et al. Variable intra-tumor genomic heterogeneity of multiple lesions in patients with hepatocellular carcinoma[J]. Gastroenterology,2016,150(4):998-1008. [34] CHEN XP,LONG X,JIA WL,et al. Viral integration drives multifocal HCC during the occult HBV infection[J]. J Exp Clin Cancer Res,2019,38(1):261. [35] AMIROUCHENE-ANGELOZZI N,SWANTON C,BARDELLI A. Tumor evolution as a therapeutic target[J]. Cancer Discov,2017.[Online ahead of print] [36] FALTAS BM,PRANDI D,TAGAWA ST,et al. Clonal evolution of chemotherapy-resistant urothelial carcinoma[J]. Nat Genet,2016,48(12):1490-1499. [37] WANG J,CAZZATO E,LADEWIG E,et al. Clonal evolution of glioblastoma under therapy[J]. Nat Genet,2016,48(7):768-776. [38] LEE JK,WANG J,SA JK,et al. Spatiotemporal genomic architecture informs precision oncology in glioblastoma[J]. Nat Genet,2017,49(4):594-599. [39] SCHULZE K,NAULT JC,VILLANUEVA A. Genetic profiling of hepatocellular carcinoma using next-generation sequencing[J]. J Hepatol,2016,65(5):1031-1042. [40] Cancer Genome Atlas Research Network. Comprehensive and integrative genomic characterization of hepatocellular carcinoma[J]. Cell,2017,169(7):1327-1341. e23. [41] DING X,HE M,CHAN A,et al. Genomic and epigenomic features of primary and recurrent hepatocellular carcinomas[J]. Gastroenterology,2020.[Online ahead of print]
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