Nat Commun: How to predict the response of meningeal cancer patients to immunotherapy?

Meningeal carcinoma-the infiltration of tumor cells into the meninges and cerebrospinal fluid-is a particularly devastating complication of solid malignancies because it usually kills quickly, with a median survival of about 4-6 weeks
.

About 5-8% of cancer patients will develop LMD, and the more common ones include breast cancer , lung cancer and melanoma

Breast cancer

In addition, in the past decade, the incidence of LMD has risen due to improved patient survival through better tolerability and more effective treatment strategies
.

Therefore, there is an urgent need for an effective systemic therapy for the treatment of LMD, because the therapeutic effects of current measures (such as craniocerebral radiation and intrathecal therapy) are controversial and have obvious adverse reactions

Immune checkpoint inhibitors (ICI) have revolutionized the field of oncology and have shown significant response rates in various metastatic, chemotherapy-refractory solid tumors
.

Recently, ICI has become a promising option for the treatment of central nervous system (CNS) metastases

Immune T cell infiltration and programmed death ligand 1 (PD-L1) is expressed in various histological brain metastases (BM), indicating that ICI may be effective in central nervous system infiltration and programming of T cells Death ligand 1 (PD-L1) is expressed in various histological brain metastases (BM), indicating that ICI may be effective on the central nervous system

Develop the scRNA/cfDNA method for longitudinal collection of CSF samples before and after ICI treatment

Developed the scRNA/cfDNA method of longitudinally taking CSF samples before and after ICI treatmentDeveloped the scRNA/cfDNA method of longitudinally taking CSF samples before and after ICI treatment

Recently, in order to study the efficacy of immune checkpoint inhibitors (ICI) in patients with LMD , researchers completed two phase II clinical trials
.

Researchers conducted single-cell RNA and cell-free DNA analysis of the longitudinal cerebrospinal fluid (CSF) of selected patients to study the cellular basis and molecular characteristics of the patient's trajectory observed in these experiments

To study the efficacy of immune checkpoint inhibitors (ICI) in patients with LMD To study the efficacy of immune checkpoint inhibitors (ICI) in patients with LMD

The researchers also restored the immune and malignant cell types in the CSF, described the changes in cell behavior after ICI, and determined the genomic characteristics related to the corresponding clinical phenomenon

Determine the genomic features related to the corresponding clinical phenomenon Determine the genomic features related to the corresponding clinical phenomenon

In summary, this study describes the liquid LMD tumor microenvironment before and after ICI treatment, and demonstrates the clinical utility of cell-free and single-cell genome sequencing in LMD research

 

Original source:

Original source:

Sanjay M.

Sanjay M.

 

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