Genetic and transcriptional insights into immune checkpoint blockade response and survival: lessons from melanoma and beyond

Abstract Background Integration of immune checkpoint inhibitors (ICIs) with non-immune therapies relies on identifying combinatorial biomarkers, which are essential for patient stratification and personalized treatment. Methods We analyzed genomic and transcriptomic data from pretreatment tumor samp...

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Main Authors: Jiaxin Wen, Yanfeng Wang, Song Wang, Yuxin Liang, Xiaozhen Hu, Qiuxiang Ou, Hua Bao, Kuo Zhao, Youyu Wang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Translational Medicine
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Online Access:https://doi.org/10.1186/s12967-025-06467-6
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author Jiaxin Wen
Yanfeng Wang
Song Wang
Yuxin Liang
Xiaozhen Hu
Qiuxiang Ou
Hua Bao
Kuo Zhao
Youyu Wang
author_facet Jiaxin Wen
Yanfeng Wang
Song Wang
Yuxin Liang
Xiaozhen Hu
Qiuxiang Ou
Hua Bao
Kuo Zhao
Youyu Wang
author_sort Jiaxin Wen
collection DOAJ
description Abstract Background Integration of immune checkpoint inhibitors (ICIs) with non-immune therapies relies on identifying combinatorial biomarkers, which are essential for patient stratification and personalized treatment. Methods We analyzed genomic and transcriptomic data from pretreatment tumor samples of 342 melanoma patients treated with ICIs to identify mutations and expression signatures associated with ICI response and survival. External validation and mechanistic exploratory analyses were conducted in two additional datasets to assess generalizability. Results Responders were more likely to have received anti-PD-1 therapy rather than anti-CTLA-4 and exhibited a higher tumor mutation burden (both P < 0.001). Mutations in the dynein axonemal heavy chain (DNAH) family genes, specifically DNAH2 (P = 0.03), DNAH6 (P < 0.001), and DNAH9 (P < 0.01), were enriched in responders. The combined mutational status of DNAH 2/6/9 effectively stratified patients by progression-free survival (hazard ratio [HR]: 0.69; 95% confidence interval [CI] 0.51–0.92; P = 0.013) and overall survival (HR: 0.58; 95% CI 0.43–0.78; P < 0.001), with consistent association observed in the validation cohort (HR: 0.28; 95% CI 0.12–0.61; P < 0.001). DNAH-altered melanomas exhibited upregulation of chemokine signaling, cytokine-cytokine receptor interaction, and cell cycle-related pathways, along with elevated expression of immune-related signatures in interferon signaling, cytolytic activity, T cell function, and immune checkpoints. Using LASSO logistic regression, we identified a 26-gene composite signature predictive of clinical response, achieving an area under the curve (AUC) of 0.880 (95% CI 0.825–0.936) in the training dataset and 0.725 (95% CI 0.595–0.856) in the testing dataset. High-risk patients, stratified by the expression levels of a 13-gene signature, demonstrated significantly shorter overall survival in both datasets (HR: 3.35; P < 0.001; HR: 2.93; P = 0.002). Conclusions This analysis identified potential molecular determinants of response and survival to ICI treatment. Insights from melanoma biomarker research hold significant promise for translation into other malignancies, guiding individualized anti-tumor immunotherapy.
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spelling doaj-art-c040f18ee7444db2b7668770bb0807872025-08-20T02:20:01ZengBMCJournal of Translational Medicine1479-58762025-04-0123111410.1186/s12967-025-06467-6Genetic and transcriptional insights into immune checkpoint blockade response and survival: lessons from melanoma and beyondJiaxin Wen0Yanfeng Wang1Song Wang2Yuxin Liang3Xiaozhen Hu4Qiuxiang Ou5Hua Bao6Kuo Zhao7Youyu Wang8Department of Thoracic Surgery, Chinese PLA General HospitalDepartment of Pathology, Beidahuang Industry Group General HospitalGeneseeq Research Institute, Nanjing Geneseeq Technology IncDepartment of Pathology, Lanzhou University Second HospitalDepartment of Scientific Affairs, Mabwell (Shanghai) Biotech Co., Ltd.Geneseeq Research Institute, Nanjing Geneseeq Technology IncGeneseeq Research Institute, Nanjing Geneseeq Technology IncDay Care Ward, Tianjin Cancer Hospital Airport HospitalDepartment of Thoracic Surgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaAbstract Background Integration of immune checkpoint inhibitors (ICIs) with non-immune therapies relies on identifying combinatorial biomarkers, which are essential for patient stratification and personalized treatment. Methods We analyzed genomic and transcriptomic data from pretreatment tumor samples of 342 melanoma patients treated with ICIs to identify mutations and expression signatures associated with ICI response and survival. External validation and mechanistic exploratory analyses were conducted in two additional datasets to assess generalizability. Results Responders were more likely to have received anti-PD-1 therapy rather than anti-CTLA-4 and exhibited a higher tumor mutation burden (both P < 0.001). Mutations in the dynein axonemal heavy chain (DNAH) family genes, specifically DNAH2 (P = 0.03), DNAH6 (P < 0.001), and DNAH9 (P < 0.01), were enriched in responders. The combined mutational status of DNAH 2/6/9 effectively stratified patients by progression-free survival (hazard ratio [HR]: 0.69; 95% confidence interval [CI] 0.51–0.92; P = 0.013) and overall survival (HR: 0.58; 95% CI 0.43–0.78; P < 0.001), with consistent association observed in the validation cohort (HR: 0.28; 95% CI 0.12–0.61; P < 0.001). DNAH-altered melanomas exhibited upregulation of chemokine signaling, cytokine-cytokine receptor interaction, and cell cycle-related pathways, along with elevated expression of immune-related signatures in interferon signaling, cytolytic activity, T cell function, and immune checkpoints. Using LASSO logistic regression, we identified a 26-gene composite signature predictive of clinical response, achieving an area under the curve (AUC) of 0.880 (95% CI 0.825–0.936) in the training dataset and 0.725 (95% CI 0.595–0.856) in the testing dataset. High-risk patients, stratified by the expression levels of a 13-gene signature, demonstrated significantly shorter overall survival in both datasets (HR: 3.35; P < 0.001; HR: 2.93; P = 0.002). Conclusions This analysis identified potential molecular determinants of response and survival to ICI treatment. Insights from melanoma biomarker research hold significant promise for translation into other malignancies, guiding individualized anti-tumor immunotherapy.https://doi.org/10.1186/s12967-025-06467-6Immune checkpoint inhibitorClinical responseBiomarkerDNAHGene expression
spellingShingle Jiaxin Wen
Yanfeng Wang
Song Wang
Yuxin Liang
Xiaozhen Hu
Qiuxiang Ou
Hua Bao
Kuo Zhao
Youyu Wang
Genetic and transcriptional insights into immune checkpoint blockade response and survival: lessons from melanoma and beyond
Journal of Translational Medicine
Immune checkpoint inhibitor
Clinical response
Biomarker
DNAH
Gene expression
title Genetic and transcriptional insights into immune checkpoint blockade response and survival: lessons from melanoma and beyond
title_full Genetic and transcriptional insights into immune checkpoint blockade response and survival: lessons from melanoma and beyond
title_fullStr Genetic and transcriptional insights into immune checkpoint blockade response and survival: lessons from melanoma and beyond
title_full_unstemmed Genetic and transcriptional insights into immune checkpoint blockade response and survival: lessons from melanoma and beyond
title_short Genetic and transcriptional insights into immune checkpoint blockade response and survival: lessons from melanoma and beyond
title_sort genetic and transcriptional insights into immune checkpoint blockade response and survival lessons from melanoma and beyond
topic Immune checkpoint inhibitor
Clinical response
Biomarker
DNAH
Gene expression
url https://doi.org/10.1186/s12967-025-06467-6
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