Lymphocyte-to-monocyte ratio as a prognostic and potential tumor microenvironment indicator in advanced soft tissue sarcoma treated with first-line doxorubicin therapy

Abstract Prognostic value of hematologic indices and their association with the tumor microenvironment (TME) remain unclear in advanced soft tissue sarcoma (STS). We aimed to evaluate their prognostic value and correlation with the TME status in advanced STS treated with first-line doxorubicin (DXR) therapy. Clinical data and three hematological indices, including lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio, were collected from 149 patients with advanced STS. The TME status was pathologically examined by CD3, CD68, and CD20 staining of resected tumor slides. In a multivariate Cox analysis, low LMR and absence of primary tumor resection were independently associated with worse overall survival (OS) (HR 3.93, p = 0.001; HR 1.71, p = 0.03). A prognostic model using these variables predicted OS with greater area under curves than those obtained using Systemic Inflammatory Score and Glasgow Prognostic Score. The LMR significantly correlated with the tumoral CD3/CD68-positive cell ratio in surgical specimens (R = 0.959, p = 0.04). In conclusion, LMR was a prognostic factor in advanced STS treated with first-line DXR therapy. LMR could partially reflect anti-tumor immunity in the TME and have the prognostic value. The potential role of LMR as an indicator of TME status warrants further investigation

Single-cell multiomics profiling reveals heterogeneous transcriptional programs and microenvironment in DSRCTs

International audienceDesmoplastic small round cell tumor (DSRCT) is a rare, aggressive sarcoma driven by the EWSR1::WT1 chimeric transcription factor. Despite this unique oncogenic driver, DSRCT displays a polyphenotypic differentiation of unknown causality. Using single-cell multi-omics on 12 samples from five patients, we find that DSRCT tumor cells cluster into consistent subpopulations with partially overlapping lineage- and metabolism-related transcriptional programs. In vitro modeling shows that high EWSR1::WT1 DNA-binding activity associates with most lineage-related states, in contrast to glycolytic and profibrotic states. Single-cell chromatin accessibility analysis suggests that EWSR1::WT1 binding site variability may drive distinct lineage-related transcriptional programs, supporting some level of cell-intrinsic plasticity. Spatial transcriptomics reveals that glycolytic and profibrotic states specifically localize within hypoxic niches at the periphery of tumor cell islets, suggesting an additional role of tumor cell-extrinsic microenvironmental cues. We finally identify a single-cell transcriptomics-derived epithelial signature associated with improved patient survival, highlighting the clinical relevance of our findings

La déficience de PBRM1 confère une létalité synthétique aux inhibiteurs de la réparation de l'ADN dans le cancer

International audienceInactivation of Polybromo 1 (PBRM1), a specific subunit of the PBAF chromatin remodeling complex, occurs frequently in cancer, including 40% of clear cell renal cell carcinomas (ccRCC). To identify novel therapeutic approaches to targeting PBRM1-defective cancers, we used a series of orthogonal functional genomic screens that identified PARP and ATR inhibitors as being synthetic lethal with PBRM1 deficiency. The PBRM1/PARP inhibitor synthetic lethality was recapitulated using several clinical PARP inhibitors in a series of in vitro model systems and in vivo in a xenograft model of ccRCC. In the absence of exogenous DNA damage, PBRM1-defective cells exhibited elevated levels of replication stress, micronuclei, and R-loops. PARP inhibitor exposure exacerbated these phenotypes. Quantitative mass spectrometry revealed that multiple R-loop processing factors were downregulated in PBRM1-defective tumor cells. Exogenous expression of the R-loop resolution enzyme RNase H1 reversed the sensitivity of PBRM1-deficient cells to PARP inhibitors, suggesting that excessive levels of R-loops could be a cause of this synthetic lethality. PARP and ATR inhibitors also induced cyclic GMP-AMP synthase/stimulator of interferon genes (cGAS/STING) innate immune signaling in PBRM1-defective tumor cells. Overall, these findings provide the preclinical basis for using PARP inhibitors in PBRM1-defective cancers. SIGNIFICANCE: This study demonstrates that PARP and ATR inhibitors are synthetic lethal with the loss of PBRM1, a PBAF-specific subunit, thus providing the rationale for assessing these inhibitors in patients with PBRM1-defective cancer.L'inactivation de Polybromo 1 (PBRM1), une sous-unité spécifique du complexe de remodelage de la chromatine PBAF, se produit fréquemment dans le cancer, y compris dans 40% des carcinomes rénaux à cellules claires (ccRCC). Afin d'identifier de nouvelles approches thérapeutiques pour cibler les cancers déficients en PBRM1, nous avons utilisé une série de cribles génomiques fonctionnels orthogonaux qui ont identifié les inhibiteurs PARP et ATR comme étant synthétiquement létaux en cas de déficience en PBRM1. La létalité synthétique des inhibiteurs de PBRM1/PARP a été récapitulée en utilisant plusieurs inhibiteurs cliniques de PARP dans une série de systèmes modèles in vitro et in vivo dans un modèle de xénogreffe de ccRCC. En l'absence de lésions exogènes de l'ADN, les cellules déficientes en PBRM1 présentaient des niveaux élevés de stress de réplication, de micronoyaux et de boucles R. L'exposition à un inhibiteur de PARP a exacerbé la létalité synthétique. L'exposition à un inhibiteur de PARP a exacerbé ces phénotypes. La spectrométrie de masse quantitative a révélé que plusieurs facteurs de traitement des boucles R étaient régulés à la baisse dans les cellules tumorales défectueuses de PBRM1. L'expression exogène de l'enzyme de résolution des boucles R, la RNase H1, a inversé la sensibilité des cellules PBRM1 déficientes aux inhibiteurs de la PARP, ce qui suggère que des niveaux excessifs de boucles R pourraient être une cause de cette létalité synthétique. Les inhibiteurs de PARP et d'ATR ont également induit une signalisation immunitaire innée de type GMP cyclique-AMP synthase/stimulateur des gènes de l'interféron (cGAS/STING) dans les cellules tumorales déficientes en PBRM1. Dans l'ensemble, ces résultats fournissent une base préclinique pour l'utilisation des inhibiteurs de PARP dans les cancers déficients en PBRM1. SIGNIFICATION : Cette étude démontre que les inhibiteurs de PARP et d'ATR sont synthétiquement létaux en cas de perte de PBRM1, une sous-unité spécifique du PBAF, ce qui justifie l'évaluation de ces inhibiteurs chez les patients atteints d'un cancer déficient en PBRM1